US20110022083A1 - Methods and devices for repairing and anchoring damaged tissue - Google Patents
Methods and devices for repairing and anchoring damaged tissue Download PDFInfo
- Publication number
- US20110022083A1 US20110022083A1 US12/509,112 US50911209A US2011022083A1 US 20110022083 A1 US20110022083 A1 US 20110022083A1 US 50911209 A US50911209 A US 50911209A US 2011022083 A1 US2011022083 A1 US 2011022083A1
- Authority
- US
- United States
- Prior art keywords
- suture
- anchoring
- knot
- head
- tissue
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06166—Sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0458—Longitudinal through hole, e.g. suture blocked by a distal suture knot
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0475—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery using sutures having a slip knot
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0477—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery with pre-tied sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B2017/06052—Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
Definitions
- the present invention relates in general to devices, systems and methods for repairing and anchoring damaged tissue, and more particularly, to devices, systems and methods for anchoring suture to tissue.
- Suture anchor tissue anchor
- the sutures can also be passed through or around the tissue according to a variety of surgical techniques to secure the repair.
- the sutures can also interconnect two or more anchors used to perform the repair.
- Suture anchors have been fabricated with bodies formed from a variety of materials including nonabsorbable materials such as metals and durable polymers, as well as bioabsorbable materials such as absorbable polymers, bioceramics, absorbable composites and processed bone.
- Anchors can be designed for fixation with respect to tissue using external screw threads on an anchor body, an expandable body, toggling action, extendable components such as barbs, or other mechanical retention means.
- Sutures can be connected through or around suture anchors in a fixed or a sliding manner, for example, using eyelets or other passages in an anchor body, and can be secured using stationary or sliding knots, interference among anchor components, interference between an anchor and surrounding tissue, or other means.
- Some suture anchors are designed for suture to slide unidirectional through or around the anchor, enabling a surgical repair to be tightened by tensioning a portion of the suture with respect to the anchor.
- suture anchors are used with sutures to reattach damaged tendons or ligaments to bone, to tighten compromised tissue surrounding articulating joints, and to repair tears in cartilage, such as torn meniscal cartilage in a knee.
- two or more anchors joined by an adjustable length of suture enable a tissue tear to be cinched closed, or compromised tissue to be stabilized.
- suture anchor design Of great importance in suture anchor design is maximizing the retention strength of the anchor in tissue, to minimize the risk of anchor breakage or pullout from tissue when an attached suture is tensioned with respect to the anchor.
- One common approach to maximizing anchor retention strength is to use physically larger anchors than might be preferable to minimize surgical trauma caused by the procedure used to implant the anchor. Not only does the implantation of a larger anchor generally require a larger and therefore more traumatic surgical incision than would be required to implant a smaller anchor, but the tools required to implant or deploy a larger anchor may also be correspondingly larger. Compounding this issue, the process of deploying an anchor in tissue can require both substantially vertical access to the tissue repair site, and significantly deeper penetration into or through the tissue than the depth required to retain the anchor after deployment in tissue.
- non-metallic suture anchors rather than metallic suture anchors. While some nonmetallic anchors can provide advantages over metallic anchors with respect to bioabsorbability or radiolucence, many nonmetallic anchors provide significantly lower mechanical strength than metallic anchors, increasing the potential for mechanical failure of the surgical repair during or post-surgery. For example, suture may cut through relatively soft materials used to fabricate a nonmetallic anchor, a process often called “cheese-wiring.” With metallic suture anchors, the interface between suture and the anchor must also be carefully designed to protect attached suture from breakage. For example, a metallic suture anchor may require precision polishing to minimize suture failure where suture contacts the much harder metal.
- suture anchoring devices systems and methods for repairing damaged tissue that overcome the limitations and disadvantages of known suture anchors.
- a need also exists for suture anchors, deployment tools and methods that minimize the surgical trauma associated with the implantation of an anchor of any given size.
- the present invention generally provides devices, systems and methods for anchoring suture to tissue.
- One aspect of the present invention is a method for anchoring a suture length to human tissue.
- the method comprises the steps of providing a preformed knot configuration to a first portion of the suture length, positioning the preformed knot configuration into an opening in a portion of the human tissue, and expanding the preformed knot configuration in at least one physical dimension to form an anchoring knot, so as to engage the anchoring knot against the tissue.
- the preformed knot configuration is reduced in length and increased in a cross-sectional dimension when reconfigured to form the anchoring knot.
- the anchoring knot can be formed behind a tissue wall, or within bulk tissue, which can be soft tissue or bone.
- the preformed knot configuration can be formed from a single line of suture or from joined lines of suture that can be of a single structure and material, or of different structures and materials.
- the preformed suture configuration is formed by intertwining portions of suture using any of a variety of methods including, but not limited to chain-knotting, braiding and crocheting.
- the step of reconfiguring the preformed knot configuration into an anchoring knot includes placing an abutment against the preformed knot configuration and moving the suture length relative to the abutment to cause the preformed knot configuration to bunch up and increase in cross sectional area as the anchoring knot.
- the preformed knot configuration can be delivered to tissue through an inserter tube.
- the inserter tube is passed though a tissue wall, and the anchoring knot is formed behind the tissue wall.
- the preformed knot configuration does not protrude more than 5 mm beyond the wall before fully forming the anchoring knot.
- the diameter of the anchoring knot is at least twice the diameter of the inserter tube.
- the suture unit includes a first preformed knot configuration along a portion of a length of suture.
- the first preformed knot configuration has a maximum diameter along the suture length and is reconfigurable into a first anchoring knot having a minimum diameter that is at least five times larger than the first preformed knot configuration maximum diameter.
- the first preformed knot configuration can be formed from a single line of suture or from joined lines of suture that can be of a single structure and material, or of different structures and materials.
- the preformed suture configuration is formed by intertwining portions of suture, using methods including, but not limited to chain-knotting, braiding and crocheting.
- the first preformed knot configuration includes a portion of suture formed into a loop closed with a sliding knot that in one embodiment is positioned within the first preformed knot configuration.
- the suture unit can include a second preformed knot configuration expandable into a second anchoring knot.
- FIG. 1 a through FIG. 1 d illustrate an embodiment of a suture-anchoring device and its deployment according to the present invention.
- FIG. 2 a through FIG. 2 d illustrate a nonsliding embodiment of a suture fixation device according to the present invention comprising a twisted braid suture head.
- FIG. 3 a through FIG. 3 c illustrate nonsliding embodiments of suture fixation devices according to the present invention comprising crocheted suture heads.
- FIG. 4 a through FIG. 4 d illustrate sliding embodiments of suture anchoring devices according to the present invention.
- FIG. 5 a through FIG. 5 d illustrate embodiments of suture anchoring devices according to the present invention comprising interpenetrating suture.
- FIG. 6 a and FIG. 6 b illustrate an embodiment of a suture anchoring device applicable to repairing a meniscus in a knee according to the present invention.
- FIG. 7 a and FIG. 7 b illustrate an embodiment of a delivery tool of the present invention that can be used to deliver the anchoring device illustrated in FIG. 6 a and FIG. 6 b to tissue.
- FIG. 8 a and FIG. 8 b illustrate an embodiment of a delivery tool of the present invention including a curved delivery needle.
- FIG. 9 a through FIG. 9 k illustrate an embodiment of a surgical repair procedure of the present invention, for repairing a torn meniscus in a knee.
- FIG. 10 a and FIG. 10 b illustrate an embodiment of a delivery tool of the present invention for single-location anchoring and for daisy-chaining anchoring locations.
- FIG. 11 a through FIG. 11 i illustrate an embodiment of a daisy-chaining anchoring procedure of the present invention.
- FIG. 12 a through FIG. 12 e illustrate an embodiment of delivery of suture anchoring devices of the present invention into hard tissue.
- FIG. 13 illustrates an embodiment of a sub-cortically dilated hole in a bone for receiving a suture anchoring device of the present invention.
- FIG. 14 a through FIG. 14 d illustrate an alternative embodiment of a delivery device of the present invention.
- FIG. 15 a through FIG. 15 d illustrate an embodiment of a suture anchoring system of the present invention wherein a suture head is used in conjunction with an intermediate anchoring implant.
- FIG. 16 a through FIG. 16 d illustrate another embodiment of an anchoring system of the present invention wherein a suture head is deployed internally to an intermediate anchoring implant.
- the present invention generally provides devices, systems and methods for anchoring suture to tissue.
- tissue is used herein to refer to any natural body tissue including, but not limited to cartilage, skin, muscle, bone, tendon, ligament and organs, as well as to prosthetic materials such as grafts or other prosthetics that can be repaired or attached to natural body tissues with sutures and anchoring devices.
- suture anchoring devices fabricated substantially from surgical suture or any elongated, thread-like materials that can be used as medical devices (hereinafter, “suture”) are disclosed herein.
- the suture can comprise a single filament or a plurality of interwoven filaments, and can have any cross-sectional shape including, but not limited to a substantially circular cross section, and a flattened ribbon or tape-like cross section. Further, the suture can be non-absorbable, bioabsorbable, or partially bioabsorbable. Without deviating from the intent or scope of the invention, the suture material can be mechanically or chemically modified, treated or coated to enhance lubricity or knot-holding ability, to elute a medicament, or for any combination of the aforementioned or other therapeutic purposes. Further, although various embodiments of anchoring devices in accordance with the invention can be constructed entirely of suture, additional components such as clips or adhesives can be included without deviating from the intent or scope of the invention.
- An anchoring device generally comprises one or more segment of suture (hereinafter, suture tail) extending from an anchoring member having a longitudinally elongated, small cross section initial configuration (hereinafter, a suture head).
- suture tail an anchoring member having a longitudinally elongated, small cross section initial configuration
- the suture head Upon deployment, the suture head is reconfigured (collapsed) to a longitudinally compressed configuration (an anchoring knot) of correspondingly larger cross-section than the suture head. That is, the anchoring knot has a larger cross sectional area and a larger average cross sectional dimension (hereinafter, cross-sectional dimension) than the corresponding dimensions of the suture head.
- the suture anchoring device for delivery to tissue, is disposed in a cannulated delivery needle having an outer diameter substantially smaller than the cross-sectional dimension of the anchoring knot.
- collapsing a suture head to an anchoring knot is accomplished by tensioning a specific one or more (collapse tail) of the one or more suture tail, with respect to the suture head.
- FIG. 1 a schematically illustrates an embodiment of a suture-anchoring device 100 according to the present invention.
- the suture anchoring device 100 illustrated undeployed in FIG. 1 a , comprises a suture head 102 having a first head end 104 , a second head end 106 , a head length 108 therebetween and an undeployed cross-sectional dimension 110 that is smaller than the head length 108 .
- a first suture tail 112 is seen to extend substantially from the first head end 104 .
- a second suture tail 114 extends substantially from the second head end 106 .
- the second suture tail 114 comprises a closed loop of suture extending from the second head end 106 .
- two or more suture tails extend from one or both of the first 104 and the second head end 106 .
- the suture head 102 comprises a longitudinally extended, preformed knot configuration, by which we mean any braided, crocheted, woven, knotted or otherwise configured section of suture that, for deployment and fixation with respect to tissue, can be readily collapsed into a longitudinally compressed, expanded cross-section form referred to herein as an anchoring knot.
- the suture head 102 is seen to be disposed in a cannulated delivery needle 116 for delivery into or through tissue 118 .
- the delivery needle 116 has a distal delivery end 120 , an outer diameter 122 and an inner diameter 124 . Further, the delivery needle 116 can be straight or curved along its length. In an embodiment, the delivery end 120 includes a tissue-penetrating point 126 . In another embodiment (not illustrated), the delivery end 120 is not pointed.
- a piston 128 having a longitudinal piston cannulation 130 therethrough is seen to be slidingly disposed within the delivery needle 116 , proximal to the suture head 102 .
- the first suture tail 112 is seen to pass proximally from the suture head 102 through the piston cannulation 130 .
- the suture head 102 is delivered from the delivery needle 116 to the tissue 118 by pushing the piston 128 distally against the suture head 102 to expel the suture head 102 from the delivery needle 116 .
- the piston 128 is seen to abut the expelled suture head 102 .
- the piston 128 is coupled to a proximal handle (not illustrated) that provides control of the longitudinal position of the piston 128 within the delivery needle 116 .
- the suture head 102 is delivered from the delivery needle 116 by distally pulling the second suture tail 114 .
- the needle 116 is straight.
- the needle 116 is curved and the piston 128 is flexible so as to enable the piston 128 to slide along the curve for delivery of the suture head 102 from the needle 116 .
- the suture head 102 substantially comprises suture, it is also flexible for sliding through a curved needle.
- the suture head 102 is collapsed to form an anchoring knot 136 .
- the suture head 102 is collapsed to the anchoring knot 136 by tensioning 138 the first suture tail 112 (a collapse tail) with respect to the suture head 102 after the suture head 102 has been pushed entirely out of the distal end 120 of the needle 116 by the piston 128 .
- the piston 128 abutting the suture head 102 provides a counter force to the tensioning 138 of the first suture tail 112 with respect to the suture head 102 , to collapse the suture head 102 to the anchoring knot 136 .
- the term “collapse tail” is used herein to describe any suture tail that, when tensioned with respect to a suture head, can be used to collapse the suture head to an anchoring knot.
- the anchoring knot 136 has a knot length 140 that is shorter than the head length 108 , and a correspondingly increased cross section 142 , determined substantially by the volume of suture originally comprising the suture head 102 .
- the first suture tail 112 is tensioned concurrently with the suture head 102 being expelled from the distal end 120 of the needle 116 , collapsing the suture head 102 to the anchoring knot 136 as it emerges from the needle 116 .
- the suture head 102 does not extend distally from the delivery needle 116 the full head length 108 during deployment, but instead extends only the knot length 140 . This shallower extension can provide deployment of the anchoring device 100 that minimizes surgical trauma to tissue positioned distally beyond, but in proximity to the distal end of the delivery needle.
- FIG. 1 d illustrates a fully deployed anchoring device 144 , wherein the needle 116 is seen to have been removed, and the anchoring knot 136 is anchored with respect to the tissue 118 , leaving the first suture tail 112 available for connection to tissue or to another anchoring device, or for any other surgical step requiring a suture that is anchored to tissue.
- the anchoring knot 136 can be deployed behind a tissue wall as illustrated in FIG. 1 d , or within bulk tissue, for example, within a bone for anchoring suture to the bone.
- two or more suture heads, interconnected by suture are disposed in a needle for surgical procedures requiring two or more tissue anchoring points.
- the anchoring knot 136 has a knot length 140 that is less than the head length 108 , and a deployed cross sectional dimension 142 that is correspondingly greater than the undeployed cross sectional dimension 110 , and greater than the outer diameter 122 of the needle 116 .
- the anchoring knot 136 is amorphous, that is, having an incompletely predetermined external shape following collapse from the suture head 102 to the anchoring knot 136 .
- anchoring knots formed from suture heads according to the various embodiments of the present invention are amorphous. Although neither the suture head 102 nor the anchoring knot 136 have a completely predetermined shape, either can be reasonably described as having a length and a diameter transverse to the length, the diameter approximately defined by the average cross-sectional dimension transverse to the length.
- the head length 108 is between approximately ten and fifty times the undeployed cross-sectional dimension 110
- the deployed cross-sectional dimension 142 is between three and ten times the undeployed cross-sectional dimension 110 .
- the suture-anchoring device 100 can be fabricated substantially from a single continuous length of suture, or from a plurality of coupled lengths of suture.
- the plurality of coupled lengths can include a single type of suture or a combination of suture types and sizes.
- the one or more suture tail can be fixedly coupled to the anchoring knot, or slidably coupled therethrough.
- the inner diameter 124 of the needle 116 is less than about six times a diameter of the suture material from which the suture head is configured. In another embodiment, the inner diameter 124 of the needle 116 is less than about four times a diameter of the suture material from which the suture head is configured.
- the design of the suture head substantially determines the overall design and procedural details of delivery and deployment.
- the design of the suture head also determines the pull-out strength of the deployed anchoring knot, and the anchor density, that is, the mass of suture material in an anchoring knot having a given cross-sectional dimension.
- Many anchoring device designs are possible within the scope of the present invention. For nonlimiting descriptive purposes herein, these designs are grouped into two general categories respectively called non-sliding embodiments, wherein all suture tails extending from a fully deployed anchoring knot are fixed thereto substantially without sliding through the knot, and sliding embodiments, wherein at least one length of suture slidingly passes through the fully deployed anchoring knot. Sliding embodiments are advantageous for some surgical applications, for example, where it is desirable to tension suture between a deployed anchoring member and attached tissue, to draw two or more anchoring devices together to close a tissue tear, or to gather together intervening tissue between anchoring devices.
- the anchoring device comprises at least a first length of suture and a second length of suture.
- the first length of suture generally comprises the bulk of a suture head (and, following deployment, a corresponding anchoring knot).
- the second length of suture comprises two suture tails and is slidable through the anchoring knot by tensioning one or the other of the two tails individually with respect to the anchoring knot.
- the sliding embodiment can further include additional sliding sutures having corresponding pairs of suture tails.
- Sliding embodiments can also include one or more fixed suture tail that can comprise a portion of the first length of suture, or an additional length of suture fixedly connected, for example, tied, to the first length of suture. Further, depending on the specific design of the suture head, one or more suture tail can comprise one or both of a collapse tail and a sliding tail.
- Nonsliding embodiments can comprise a single length of suture or a plurality of suture lengths that are fixedly joined together, for example, by one or more knot.
- Nonsliding embodiments include a suture head from which one or more suture tail extends, at least one of the one or more suture tail comprising a collapse tail.
- a suture head according to the present invention can comprise any preformed knot configuration that can be collapsed from a longitudinally extended form to a longitudinally compressed, increased cross section anchoring knot.
- the suture head includes a plurality of openings comprising loops, penetrations or other openings formed along a first longitudinal section of suture.
- a second longitudinal section of suture comprising a collapse tail is woven through two or more of the plurality of the openings.
- One or more suture tails extends from the suture head, at least one of the one or more suture tails comprising the collapse tail.
- the first section of suture, the second section of suture and the one or more suture tail comprise a single continuous length of suture.
- the first section of suture, the second section of suture and the one or more suture tail comprise two or more joined lengths of suture.
- Anchoring devices of the present invention can include one or more of a variety of types of suture heads, and can be fabricated using a variety of methods.
- One type of suture head comprises a braided section of suture that is collapsible to an anchoring knot. Any type of suture braiding can be used to configure the suture head.
- An embodiment of a nonsliding, twisted braid suture-anchoring device is schematically illustrated in FIG. 2 a and FIG. 2 b .
- FIG. 2 a illustrates a first configuration step 200 , wherein a length of suture 202 is seen to have been formed into a starting loop 204 having a first head end 206 , a second head end 208 and a head length 210 therebetween.
- a suture tail 212 extends from the second head end 208 .
- FIG. 2 b illustrates a configured suture head 214 .
- the loop 204 has been repetitively twisted to provide a plurality of openings 216 along the head length 210 .
- the suture tail 212 is seen to have been woven through the plurality of openings 216 from the second head end 208 to the first head end 206 , and extends from the first head end 206 , where it comprises a collapse tail.
- FIG. 2 b the suture heads are generally illustrated in an expanded schematic form to support description of routing of suture therethrough.
- Any suture head disclosed herein can be readily compressed in cross section, for example, for disposition within a cannulated delivery needle, as illustrated in FIG. 1 a .
- FIG. 2 c illustrates the suture head 214 in a compressed cross section form 218 , as for disposition in a delivery needle.
- the suture head 214 can be collapsed to an anchoring knot 220 , as illustrated in FIG. 2 d , by tensioning the suture tail 212 (collapse tail) with respect to the suture head 214 .
- tensioning the first suture tail 212 with respect to the suture head 214 we mean tensioning (pulling) the first suture tail 212 away from the suture head 214 , so that the portion of the first suture tail 212 that is woven through the plurality of openings 216 is pulled further through the plurality of openings 216 and through the first head end 206 , thereby gathering or bunching the twisted suture along the head length 210 into the anchoring knot 220 .
- tensioning 222 the first suture tail 212 with respect to the suture head 214 an abutment to the first head end, for example, the piston 128 of FIG. 1 is required to hold the suture head in position for collapsing to the anchoring knot 220 .
- friction with the tissue can also retain the suture head during collapse to an anchoring knot.
- any type and diameter of suture, and any number of openings 216 for braiding or otherwise passing suture therethrough, can be used to configure a suture head according to the present invention.
- a larger number of openings generally provides a longer suture head and, upon deployment, an anchoring knot having a larger cross sectional dimension, thereby providing greater fixation strength of the anchoring knot with respect to tissue.
- a 20 mm long suture head comprises between fifteen and thirty-five openings through which suture can be woven.
- the plurality of openings is between twenty and thirty openings.
- the suture head is approximately 25 millimeters (mm) in length, and upon deployment in tissue, the suture head collapses to a substantially amorphous anchoring knot approximately five mm in diameter.
- a suture head approximately 20 mm long was configured from partially absorbable, polyethylene-containing braided suture approximately 0.5 millimeters (mm) in diameter (ORTHOCORDTM Orthopaedic Suture from DePuy Mitek, Raynham, Mass.).
- mm millimeters
- ORTHOCORDTM Orthopaedic Suture from DePuy Mitek, Raynham, Mass.
- Deployment of a similarly configured anchoring device through a 2-mm diameter hole in artificial bone having a 3-mm thick, 35-durometer cortex provided a pullout strength of approximately 22 pounds.
- Braids for example, can be formed by a variety of methods and with any number of suture sections braided together, and a suture head configured to include any braiding pattern is within the scope of the present invention. Further, braiding comprises only one of a variety of methods for configuring a suture head according to the present invention. Other methods for configuring a suture head can be adapted, for example, from other textile arts such as crocheting and weaving.
- Another anchoring device of the present invention includes a suture head configured using a chain of suture loops.
- the chain of loops can comprise a plurality of independent suture loops, a physically connected chain of discrete loops, or a plurality of loops formed along a continuous length of suture using known textile arts such as crocheting, where each of the plurality of loops in a chain is formed by pulling a section of the suture through a previously formed loop in the suture.
- the plurality of loops provides a corresponding plurality of openings through which suture can be woven.
- Nonsliding embodiments of suture anchoring devices comprising suture heads configured using crocheted suture are schematically illustrated in FIG. 3 a through FIG. 3 c .
- FIG. 3 a illustrates a crochet configuration step 230 wherein a length of suture 232 has been crocheted to define a plurality of openings 234 along a crocheted section 236 having a first crocheted end 238 and a second crocheted end 240 .
- a first suture tail 242 extends from the first crocheted end 238 and a second suture tail 244 extends from the second crocheted end 240 .
- FIG. 3 b illustrates a first embodiment 250 of a crocheted suture-anchoring device. It comprises a suture head 252 wherein the first suture tail 242 is seen to weave through one or more of the plurality of openings 234 along the crocheted section 236 from the first crocheted end 238 to the second crocheted end 240 , and extends from the second crocheted end 240 .
- the suture head 250 can be collapsed to an anchoring knot by tensioning the first suture tail 242 (collapse tail) with respect to the suture head 252 .
- FIG. 3 c illustrates a second embodiment 260 of a crocheted suture-anchoring device.
- the second embodiment 260 resembles the first embodiment 250 , with the addition that in the second embodiment 260 , after being woven from the first 238 to the second crocheted end 240 , the first suture tail 242 is returned through one or more of the plurality of openings 234 from the second crocheted end 240 to the first crocheted end 238 , to extend from the first crocheted end 238 .
- the suture head 262 can be collapsed to an anchoring knot by tensioning the first suture tail 242 (collapse tail) with respect to the suture head 262 .
- the second suture tail 244 is directly connected to and extends from the second crocheted end, and tensioning the second suture tail 244 with respect to the respective suture head 252 , 262 (providing an abutment against second crocheted end 240 does not collapse the respective suture head to an anchoring knot.
- the second suture tail 244 can be used, for example, to pull the respective suture head 252 , 262 , into a cannulated needle, for delivery to tissue or through tissue, without collapsing the respective suture head to an anchoring knot.
- FIG. 4 a through FIG. 4 d illustrate sliding embodiments of suture anchoring devices according to the present invention.
- FIG. 4 a illustrates a sliding embodiment of a twisted ring suture-anchoring device 300 .
- the twisted ring suture-anchoring device 300 comprises a suture ring 302 that is a closed ring of suture repetitively twisted to form a plurality of openings 304 between a first twist end 306 and a second twist end 308 .
- a length of suture 310 having a first suture tail 312 and a second suture tail 314 is woven through the plurality of openings 304 between the first twist end 306 and the second twist end 308 , and returning through at least one of the plurality of openings 304 near the first twist end 306 , to configure a suture head 316 having both the first 312 and the second suture tail 314 extending from the first twist end 306 .
- the suture head 316 can be collapsed to an anchoring knot by simultaneous tensioning of the first 312 and the second suture tail 314 with respect to the suture head 316 .
- the first 312 and the second suture tail 314 comprise collapse tails when tensioned simultaneously with respect to the suture head 316 .
- the length of suture 310 is not fixedly connected to the suture ring 302 , but woven therethrough to preserve slidability of the length of suture 310 through the anchoring knot.
- the length of suture 310 can slide through the anchoring knot by individually tensioning either the first 312 or the second suture tail 314 respectively, with respect to the anchoring knot.
- a suture ring used to configure a suture head according to the present invention can comprise suture formed as a continuous ring of suture material, or a length of suture closed to form the ring. Any method of closing the length of suture to a ring can be used, including but not limited to knotting, welding, gluing, or crimping with or without a binding clamp or other joining member.
- the suture ring can include a plurality of substantially parallel strands of suture about its circumference, braided, crocheted, or otherwise interlocked suture.
- the suture ring comprises a continuous ring of suture having a first circumference, that is doubled over to form a doubled suture ring having a second circumference that is substantially half the first circumference.
- FIG. 4 b illustrates a sliding embodiment of a suture-chain suture-anchoring device 322 .
- the suture-chain suture-anchoring device 322 comprises a connected chain of suture rings 324 defining a plurality of openings 326 between a first chain end 328 and a second chain end 330 .
- a length of suture 332 having a first suture tail 334 and a second suture tail 336 is woven through the plurality of openings 326 between the first chain end 328 and the second chain end 330 , then returning through at least one of the plurality of openings 326 near the first chain end 328 , to configure a suture head 338 having both the first 334 and the second suture tail 336 extending from the first chain end 328 .
- the suture head 338 can be collapsed to an anchoring knot by simultaneous tensioning of the first 334 and the second suture tail 336 with respect to the suture head 338 .
- the first 334 and the second suture tail 336 comprise collapse tails when tensioned simultaneously. As can be seen in FIG.
- the length of suture 332 is not fixedly connected to the chain of suture rings 324 , but woven therethrough to preserve slidability of the length of suture 332 through the anchoring knot.
- the length of suture 332 can slide through the anchoring knot by individually tensioning either the first 334 or the second suture tail 336 respectively, with respect to the anchoring knot.
- FIG. 4 c illustrates a sliding embodiment of a wound-ring suture-anchoring device 344 providing a sliding connection between suture and a deployed anchoring knot.
- the wound-ring suture-anchoring device 344 comprises a suture ring 346 that can be any type of suture ring described hereinabove.
- the wound-ring suture-anchoring device 344 also comprises a first length of suture 348 having a first suture tail 350 and a second suture tail 352 .
- the first length of suture 348 is wound substantially helically about the suture ring 346 to configure a suture head 354 , with the first 350 and the second suture tail 352 extending from the suture ring 346 substantially adjacent to one another about the circumference of the suture ring 346 .
- the first length of suture 348 is wound substantially helically about a second length of suture.
- the second length of suture, with the winding about it, is subsequently joined at a closure point 356 along its length to form the suture ring 346 .
- the suture head 354 can be collapsed to an anchoring knot by simultaneous tensioning of the first 350 and the second suture tail 352 with respect to the suture head 354 .
- the first 350 and the second suture tail 352 comprise collapse tails when tensioned simultaneously.
- the first length of suture 348 can slide through the anchoring knot by individually tensioning either the first 350 or the second suture tail 352 respectively, with respect to the anchoring knot.
- FIG. 4 d A sliding embodiment of a crochet-type suture-anchoring device 362 is illustrated in FIG. 4 d .
- the crochet-type suture-anchoring device 362 comprises a crocheted section of suture 364 defining a plurality of openings 366 between a first crocheted end 368 and a second crocheted end 370 .
- the crocheted section 364 is similar to the crocheted section 236 described in association with FIG. 3 a .
- the crochet-type suture-anchoring device 362 also comprises a first length of suture 372 having a first suture tail 374 and a second suture tail 376 .
- the first length of suture 372 is woven through one or more of the plurality of openings 366 between the first crocheted end 368 and the second crocheted end 370 , and returned to the first crocheted end 368 through at least one of the plurality of openings 366 near the first crocheted end 368 .
- the first 374 and the second suture tail 376 extend from the first crocheted end 368 .
- the fraction of the plurality of openings comprises approximately every third opening of the plurality of openings 366 .
- the first length of suture 372 is woven through substantially each of the plurality of openings 366 .
- the interval varies along the plurality of openings 366 between the first crocheted end 368 and the second crocheted end 370 .
- the first length of suture 372 passes through a single one of the plurality of openings 366 , the single one of the plurality of openings 366 functioning as an eyelet through which the first length of suture 372 passes.
- any number of additional lengths of suture can be independently woven through one or more of the plurality of openings, thereby providing an anchoring device having a plurality of suture legs extending therefrom (a multisuture anchoring device).
- two, three or four lengths of suture are each woven through one or more of the plurality of openings, providing anchoring devices respectively comprising four, six, or eight legs of suture extending therefrom.
- one or more suture needle with attached suture can be passed through a deployed anchoring knot to provide a multisuture anchoring device.
- the suture head 378 can be collapsed to an anchoring knot by simultaneous tensioning of the first 374 and the second suture tail 376 with respect to the suture head 378 .
- the first 374 and the second suture tail 376 comprise collapse tails when tensioned simultaneously with respect to the suture head 378 .
- the first length of suture 372 can slide through the anchoring knot by individually tensioning of either the first 374 or the second suture tail 376 respectively, with respect to the anchoring knot.
- FIG. 5 a through FIG. 5 d illustrate embodiments of suture anchoring devices comprising interpenetrating suture.
- a suture head according to these embodiments comprises a plurality of longitudinally distributed, substantially transverse penetrations through the material of a first section of suture, and a second section of suture woven through the plurality of penetrations.
- the plurality of penetrations can comprise any type of penetrations.
- the plurality of penetrations is defined using a sharp instrument such as a sewing or suturing needle connected to a suture tail.
- the plurality of penetrations comprises a plurality of slits or bores is formed through the suture material to enable weaving of a suture tail therethrough.
- a plurality of preformed penetrations is provided during fabrication of the section of suture.
- the suture itself comprises a braided material, for example, a braided suture, and the plurality of penetrations pass through the braid at a corresponding plurality of locations.
- FIG. 5 a and FIG. 5 b illustrate interpenetrating sliding embodiments.
- FIG. 5 a illustrates a first interpenetrating sliding embodiment 400 of a suture anchoring device wherein a suture head 402 comprises a suture ring 404 having a plurality of penetrations 406 distributed around its circumference.
- the suture ring 404 can be any type of suture ring disclosed herein.
- the suture head 402 further comprises a first length of suture 408 woven through the plurality of penetrations 406 , and terminating in a first suture tail 410 and a second suture tail 412 , each extending from the suture head 402 substantially adjacent to one another about the circumference of the suture ring 404 .
- the suture head 402 can be collapsed to an anchoring knot through which the first length of suture 408 can slide after the anchoring knot is formed, by simultaneously tensioning the first 410 and the second suture tail 412 with respect to the suture head 402 .
- the first 410 and the second suture tail 412 comprise collapse tails when tensioned simultaneously.
- the first length of suture 408 can slide through the anchoring knot by individually tensioning either the first 410 or the second suture tail 412 respectively, with respect to the anchoring knot.
- the suture ring 404 comprises a second length of suture that is open at a point 418 on the circumference, and the ring shape is maintained by the adjacent penetrations 420 , 422 of the second length of suture by the first length of suture 408 .
- the second length of suture penetrates the first length of suture, instead of the first length of suture 408 penetrating the second length of suture.
- FIG. 5 b illustrates a second interpenetrating sliding embodiment 424 of a suture anchoring device
- a suture head 426 comprises a first length of suture 428 having a plurality of penetrations 430 along a first portion 432 of its length, through which a second portion 434 of the length passes to define a corresponding plurality of openings 436 .
- the suture head 426 further comprises a second length of suture 438 woven through the plurality of openings 436 , and terminating in a first suture tail 440 and a second suture tail 442 , each extending from the suture head 426 .
- the suture head 426 can be collapsed to an anchoring knot through which the second length of suture 438 can slide, by simultaneously tensioning the first 440 and the second suture tail 442 with respect to the suture head 426 .
- the first 440 and the second suture tail 442 comprise collapse tails when tensioned simultaneously.
- the second length of suture 438 can slide through the anchoring knot by individually tensioning either the first 440 or the second suture tail 442 respectively, with respect to the anchoring knot.
- FIG. 5 c and FIG. 5 d illustrate interpenetrating suture nonsliding embodiments of suture anchoring devices.
- FIG. 5 c illustrates a first interpenetrating nonsliding embodiment 448 wherein a suture head 450 having a first head end 452 and a second head end 454 comprises a first length of suture 456 having a plurality of penetrations 458 along a first portion 460 of its length between the first head end 452 and the second head end 454 .
- a second portion 462 of the length passes through the plurality of penetrations 458 and extends from the first head end 452 as a suture tail 464 .
- the suture head 450 can be collapsed to an anchoring knot by tensioning the suture tail 464 with respect to the suture head 450 .
- one of the penetrations 468 of the second portion 462 through the first portion 454 is reinforced by knotting or by another means to prevent the suture head from unraveling during deployment.
- the plurality of penetrations 458 is seen to define a plurality of openings 470 along the suture head 450 between the first head end 454 and the second head end 456 .
- FIG. 5 d illustrates a second interpenetrating nonsliding embodiment 472 .
- the second nonsliding embodiment 472 comprises a suture head 474 that resembles the suture head 450 of FIG. 5 c , with the addition that in the second embodiment 472 , the suture tail 464 is seen to be reversed in direction and additionally woven through one or more of the plurality of openings 470 , to extend from the second head end 454 .
- This additional pass of the suture tail 464 provides a larger volume of suture material in the suture head 474 of the second embodiment 472 , compared with the volume of suture material in the suture head 450 of the first embodiment 448 .
- a larger volume of suture in a suture head provides a correspondingly larger anchoring knot upon deployment in tissue.
- the suture head 474 can be collapsed to an anchoring knot by tensioning the suture tail 464 with respect to the suture head 474 .
- various nonsliding embodiments can be converted to sliding embodiments by passing an additional length of suture through an opening in a nonsliding suture head before deployment.
- the second suture tail 114 comprises a closed loop of suture
- passing a length of suture through the loop before delivering the anchoring device 100 to tissue provides a sliding embodiment of the suture anchoring device, as the passed length of suture will be slidable with respect to the anchoring knot 136 .
- various sliding embodiments can be converted to nonsliding embodiments, for example, by tying a knot in one or more sliding suture tail.
- suture anchoring devices disclosed herein are within the scope of the present invention, including but not limited to variations in suture material, size, number and combinations of suture lengths used to construct the anchoring device, the number of openings through which suture comprising a collapse tail passes along a suture head, and the number of sliding and nonsliding suture tails extending from a suture head. Further, any number of suture anchoring devices can be coupled together by suture to provide multi-point anchoring systems.
- FIG. 6 a illustrates an embodiment of a dual anchoring device 500 according to the present invention that in one embodiment is used for repairing torn meniscal tissue.
- the dual anchoring device 500 comprises a first suture head 502 having a first distal end 504 and a first proximal end 506 , and a second suture head 508 having a second distal end 510 and a second proximal end 512 .
- the second suture head 508 is seen to be positioned proximal to the first suture head 502 .
- the first suture head 502 is a sliding suture head that can be any type of sliding suture head disclosed herein, or another sliding suture head.
- the first suture head 502 is a crochet-type sliding suture head similar to the suture head 378 described in association with FIG. 4 d .
- the first suture head 502 comprises two distal collapse tails 514 , 516 that are seen to extend form the first proximal end 506 toward the second suture head 508 .
- the two distal collapse tails 514 , 516 comprise a continuous length of suture that passes through the first suture head 502 .
- the two distal collapse tails 514 , 516 comprise a suture bridge between the first 502 and the second suture head 508 .
- the second suture head 508 is a non-sliding suture head that can comprise any type of nonsliding suture head disclosed herein, or another nonsliding suture head.
- the second suture head 508 resembles the crochet-type nonsliding suture head 252 described in association with FIG. 2 c , with the addition of an integrated sliding knot 518 extending from the second distal end 510 .
- the second suture head 508 also comprises a proximal collapse tail 520 extending proximally from the second proximal end 512 .
- the second suture head 508 , the sliding knot 518 , and the two distal collapse tails 514 , 516 comprise a single continuous length of suture.
- the sliding knot 518 rather than extending from the second distal end 510 , is disposed at a location 521 between second distal end 510 and a second proximal end 512 along the second suture head 508 .
- a partially expanded view 522 of the dual anchoring device 500 is shown schematically in FIG. 6 b , illustrating the configuration of an embodiment of the sliding knot 518 .
- a first one 514 of the two distal collapse tails 514 , 516 is seen to substantially comprise one portion of the sliding knot 518 , and to connect to (or be continuous with) the second suture head 508 at the second distal end 510 .
- the second distal collapse tail 516 is seen to pass through the sliding knot to extend proximally from the sliding knot 518 , continuous with a tensioning tail 524 .
- the second collapse tail 516 is also seen to pass through a suture loop 526 integral with the second suture head 508 and extending distally therefrom.
- FIG. 7 a An embodiment of a dual suture head delivery tool 530 for delivering the dual anchoring device 500 to tissue is schematically illustrated in FIG. 7 a in a cross-sectional view 532 and in FIG. 7 b in an external view 534 .
- the dual head delivery tool 530 is seen to comprise a cannulated delivery needle 536 having a distal needle end 538 , a proximal needle end 540 and a longitudinal needle cannulation 542 therebetween.
- the delivery needle 536 is proximally coupled to a cannulated handle 544 having a handle wall 546 and a substantially cylindrical handle cannulation 548 , the needle cannulation 542 being continuous with the handle cannulation 548 .
- the needle 536 is proximally reinforced by a stiffening member 550 .
- each of the needle 536 and the piston 552 is straight.
- the needle 536 comprises one or more curve between the distal needle end 538 and the proximal needle end 540 , and the piston is flexible enough to be pushed and pulled slidingly through the needle cannulation 542 .
- the piston 552 comprises a flexible tube.
- the piston 552 comprises a flexible, substantially helical coil.
- a piston positioning member 558 is fixedly connected to the piston 552 , and slidably disposed within the handle cannulation 548 .
- the positioning member 558 is an annular member disposed about the piston 552 .
- the piston positioning member 558 substantially irreversibly locks in position longitudinally when maximally advanced distally within the handle cannulation 548 . Any means of locking the piston positioning member 558 can be used.
- the piston positioning member 558 and the handle 544 comprise interlocking latching members 560 , 562 to lock the piston positioning member 558 distally within the handle 544 .
- a control member 564 is connected to the positioning member 558 , for positioning the piston 552 longitudinally within the dual head delivery tool 530 , from outside the delivery device.
- the control member is shown rotated ninety degrees about a longitudinal axis of the tool 530 in FIG. 7 a with respect to FIG. 7 b .
- the control member 564 extends laterally outward from the positioning member 558 , through a slotted opening 566 in the handle wall 546 .
- the slotted opening 566 can have any configuration that accommodates the requirements an anchoring device disposed in the delivery device, and corresponding surgical delivery requirements. In one embodiment, as illustrated in FIG. 7 a and FIG.
- the slotted opening 566 is substantially H-shaped.
- the H-shaped opening includes first and second longitudinal slots 812 , 814 having respective longitudinal positions that differ from one another along the handle wall 546 , each of the two slots being adapted by its respective position for delivery of one of the first 502 and the second suture head 508 from the delivery needle 536 .
- the slotted opening is substantially T-shaped, L-shaped, longitudinally linear, or has another configuration, respective configurations being adapted to accommodate various suture head delivery requirements
- the slotted opening comprises means for locking the piston positioning member 558 distally in the handle cannulation 548 .
- the control member 564 can comprise any means for communicating one or both of longitudinal and circumferential positioning force to the positioning member 558 and thereby to the piston 552 .
- the control member 564 is a shaft fixedly connected to the positioning member 558 through the slotted opening 566 .
- the control member 564 includes means to releasable prevent the piston from moving within the dual head delivery tool 530 .
- the control member 564 is a thumbscrew that is threaded into the positioning member 558 through the slotted opening 566 , such that rotation of the thumbscrew can be used to selectively lock and unlock the position of the piston within the dual head delivery tool 530 .
- the control member 564 is resiliently loaded with respect to the handle wall 546 to provide a predetermined resistance to movement of the control member 564 along the slotted opening 566 .
- the dual anchoring device 500 is seen to be disposed within the dual head delivery tool 530 , substantially within the needle cannulation 542 , distal to the piston distal end 554 .
- the second collapse tail 520 and the tensioning tail 524 pass proximally from the dual anchoring device 500 through the piston cannulation 557 .
- Proximal to the piston proximal end 556 the tensioning tail 524 terminates at a tensioning tail end 568 and the second collapse tail 520 terminates at a second collapse tail end 570 .
- the second collapse tail 520 also comprises a releasable holding member 572 disposed proximally to the proximal piston end 556 , outside the piston cannulation 557 .
- the releasable holding member 572 prevents the second collapse tail 520 from sliding distally through the cannulation of the piston 552 .
- the releasable holding member 572 is a releasable clamp attached to the second collapse tail 520 .
- the releasable holding member 572 is a releasable knot in the second collapse tail 520 .
- proximally tensioning the second collapse tail 520 releases the releasable knot.
- the second collapse tail 520 can slide distally through the cannulation of the piston 552 .
- the control member 564 controls the longitudinal position of the distal end of the piston 552 within the delivery needle 536 , and thereby controls the expulsion of the dual anchoring device 500 from the delivery needle 536 .
- the control member 564 can be used to selectively expel only the first suture head 502 from the delivery needle 536 for a predetermined surgical step, and selectively expel the second suture head 508 for a later surgical step, thus enabling multipoint anchoring procedures using devices and methods of the present invention.
- FIG. 8 a An embodiment of a curved needle delivery tool 574 is illustrated in FIG. 8 a .
- the curved needle delivery tool 574 generally resembles the dual head delivery tool 530 associated with FIG. 7 a and FIG. 7 b , which comprises a straight delivery needle.
- the curved needle embodiment 574 includes a cannulated curved delivery needle 576 having a distal delivery end 578 and a proximal end 580 that is rotatably coupled to a handle 584 about a common longitudinal axis 586 .
- a control member 588 is accessible on an outside surface 590 of the handle 584 .
- the curved delivery needle 576 further comprises one or more curved portion 592 , distal of which the curved needle 576 deviates from the axis 586 .
- the curved needle delivery tool 574 comprises a plurality of preferred relative rotational orientations about the axis 586 between the handle 584 and the curved needle 576 .
- the plurality of preferred orientations comprises a plurality of detents 594 circumferentially distributed about the circumference of one or both of the handle 590 and the curved needle 576 .
- angular markings are provided on one or both of the handle 584 and the curved needle 576 to indicate the relative rotational orientation between the curved needle 576 and the handle 584 .
- FIG. 8 a illustrates the curved needle delivery tool 574 in a first angular orientation 596 between the handle 584 and the curved needle 576 .
- FIG. 8 b illustrates the curved needle delivery tool 574 in a second angular orientation 598 between the handle 584 and the curved needle 576 .
- FIG. 9 a through FIG. 9 k schematically illustrate a surgical repair procedure for a torn meniscus in a knee using the dual anchoring device 500 illustrated in FIG. 6 and the dual head delivery tool 530 illustrated in FIG. 7 .
- the procedure can be performed arthroscopically or as an open surgical procedure.
- the patient is prepared according to known preparatory and surgical techniques including the provision of access to the torn meniscus.
- the following description of the procedure references FIG. 6 and FIG. 7 as well as FIG. 9 a through FIG. 9 n .
- FIG. 9 a through FIG. 9 n includes an illustration of a surgical step, in some of the figures accompanied by an illustration representing a position of the control member 564 in the substantially H-shaped slotted opening 566 as illustrated in FIG. 7 .
- FIG. 9 a illustrates a first step in which the delivery needle 536 of the dual head delivery tool 530 is seen to have been passed through a meniscus 802 that has suffered a meniscal tear 804 .
- the meniscus 802 is seen to have a first meniscal surface 806 which faces toward a femur (not shown) and a second meniscal surface 808 which faces laterally or medially away from the femur. It is preferred to minimize the protrusions on the first surface 806 facing the femur to minimize irritation etc. of such surface which bears a load from the femur.
- the delivery needle 536 is seen to have penetrated the meniscus 802 at a first location 810 , entering through the first meniscal surface 806 , and exiting through the second meniscal surface 808 .
- the first location 810 is determined by the surgeon performing the procedure, to optimize closure of the meniscal tear 804 .
- the delivery needle 536 penetrates through the meniscus 802 across the meniscal tear 804 .
- the H-shaped slotted opening 566 is seen to comprise a first longitudinal channel 812 and a second longitudinal channel 814 , each having a respective proximal end 816 , 818 and distal end 820 , 822 .
- the H-shaped slotted opening 566 further comprises a bridging channel 824 interconnecting the first 812 and the second channel 814 .
- the control member 564 is seen to be positioned at the proximal end 816 of the first channel 812 . In this position of the control member 564 , the dual anchoring device 500 is maximally retracted into the delivery needle 536 .
- the control member 564 is seen to have been repositioned to the distal end 820 of the first channel 812 , thereby expelling the first suture head 502 distally from the delivery needle 536 .
- the first channel 812 does not extend distally far enough to expel the second suture head 508 from the delivery needle 536 .
- the control member 564 is seen to have been retracted to the proximal end 816 of the first channel 812 .
- the refraction of the control member 564 collapses the first suture head 502 to a first anchoring knot 830 as the proximal piston end 556 bears against the releasable holding member 572 , transmitting tension via the proximal collapse tail 520 , the second suture head 508 , and the two distal collapse tails 514 , 516 to the first suture head 502 .
- the delivery needle 536 is seen to have been retracted from the meniscus 802 , leaving the two distal collapse tails 514 , 516 bridging between the first anchoring knot 830 and the second suture head 508 within the delivery needle 536 .
- retracting the delivery needle 536 positions the first anchoring knot 830 proximally against the second meniscal surface 808 .
- the control member can move somewhat distally in the first longitudinal channel 812 as the delivery needle 536 is retracted from the meniscus 802 .
- the control member 564 is seen to have been moved distally in the first longitudinal channel 812 and repositioned into the second longitudinal channel 814 via the bridging channel 824 .
- the delivery needle 536 is seen to have been passed through the meniscus 802 at a second location 838 , entering through the first meniscal surface 808 , and exiting through the second meniscal surface 808 .
- the second location 838 is determined by the surgeon to optimize closure of the meniscal tear 804 .
- the delivery needle 536 penetrates through the meniscus 802 across the meniscal tear 804 .
- a seventh step 840 the control member 564 is seen to have been moved to the distal end 822 of the second longitudinal channel 814 , thereby expelling the second suture head 508 from the delivery needle 536 and locking the longitudinal position of the positioning member 558 and the piston 552 .
- the second collapse tail 520 is tensioned 844 proximally to collapse the second suture head 508 to a second anchoring knot 846 .
- the releasable holding member 572 is released in this step.
- the releasable holding member 572 is a knot in the second collapse tail, and tensioning the second collapse tail 520 releases the knot, leaving the second collapse tail end 570 free to pass through the piston cannulation 557 .
- a ninth step 848 the delivery needle 536 is seen to have been retracted from the meniscus 802 , leaving the second collapse tail 520 and the tensioning tail 524 extending through the meniscus 802 and between the second anchoring knot 846 and the delivery needle 536 .
- the dual head delivery tool 530 is seen to have been removed entirely from the surgical site, leaving the second collapse tail 520 and the tensioning tail 524 extending from the second anchoring knot 846 and through the first meniscal surface 806 .
- the tensioning tail 524 transmits tension in turn through the slipknot 518 (now part of the second anchoring knot 846 ) to the second distal collapse tail 516 , through the first anchoring knot 830 and to the first distal collapse tail 514 , thereby shortening the suture between the first 830 and the second anchoring knot 846 , to close the meniscal tear 804 .
- the second collapse tail 520 and the tensioning tail 524 are seen to have been trimmed to or below the first meniscal surface 806 , resulting in a repaired meniscal tear 804 .
- one or both of the tensioning tail 524 and the second collapse tail 520 is left untrimmed, and is passed through a closed loop of suture extending distally from an additional suture head, to provide an additional “daisy-chained” suture anchoring point when the additional suture head is delivered to tissue.
- the additional suture head is the suture head 102 of FIG. 1 , wherein the second suture tail 114 comprises the closed loop of suture extending distally from the second head end 106 . Any number of additional anchoring points can be provided by this daisy-chaining process, as each deployed anchoring knot comprises at least one suture tail that can be passed through a suture loop of yet another suture head, for anchoring to tissue.
- a single suture head is disposed in a delivery needle for deployment of a single anchoring knot to tissue.
- three suture heads are disposed in a delivery needle, for sequential deployment to tissue as anchoring knots.
- one or more suture head is disposed in each of two or more delivery needles, with at least one suture bridge interconnecting suture heads disposed in two or more of the delivery needles.
- FIGS. 9 a to 9 k illustrate a tear 804 at least somewhat parallel to the second surface 808 .
- tears may form in other locations and orientations and the location of anchoring knots 830 and 846 and the path of the suture between can be altered as appropriate.
- a tear (not shown) may form in an orientation essentially orthogonal to the tear 804 , in which case the first anchoring knot 830 could be placed on one side of such tear on the second surface 808 the suture being passed through the meniscus to the first surface 806 on the same side of the tear and then being passed along the first surface 806 across the tear and then back through the meniscus on the other side of the tear to the second anchoring knot 846 on the other side of the tear and on the second surface 808 .
- all knots and other significant protrusions on the suture are kept on the second surface 808 and not on the first surface 806 facing the femur or other surfaces under load such as one which face towards the tibia (not shown).
- FIG. 10 a An embodiment of a single suture head delivery tool 860 that can be used for anchoring suture to tissue at a single location, or for daisy-chaining suture anchoring devices according to the present invention, is schematically illustrated in FIG. 10 a in a cross-sectional view 862 and in FIG. 10 b in an external view 864 .
- the single head delivery tool 860 resembles the dual head delivery tool 530 disclosed hereinabove.
- the single head delivery tool 860 is seen to comprise a cannulated delivery needle 866 having a distal needle end 868 , a proximal needle end 870 and a longitudinal needle cannulation 872 therebetween.
- the delivery needle 866 is proximally coupled to a cannulated handle 874 having a handle wall 876 and a substantially cylindrical handle cannulation 878 , the needle cannulation 872 being continuous with the handle cannulation 878 .
- the needle 866 is proximally reinforced by a stiffening member 880 .
- a cannulated piston 882 having a distal piston end 884 , a proximal piston end 886 and a longitudinal piston cannulation 888 therebetween is seen to be disposed slidably within the needle cannulation 872 , and to extend proximally into the handle cannulation 878 .
- the needle 866 can be straight or curved as disclosed hereinabove for the dual head delivery tool 530 .
- a piston positioning member 890 is fixedly connected to the piston 882 , and slidably disposed within the handle cannulation 878 .
- the piston positioning member 890 is an annular member disposed about the piston 882 .
- the piston positioning member 890 substantially irreversibly locks in position longitudinally when maximally advanced distally within the handle cannulation 878 , as disclosed hereinabove for the dual head delivery tool 530 .
- a control member 892 is connected to the positioning member 890 , for positioning the piston 882 longitudinally within the delivery tool 860 , from outside the delivery tool 860 .
- the control member 892 can be of the same construction as the control member 564 disclosed hereinabove, or of another construction.
- the control member 892 extends laterally outward from the positioning member 890 , through a slotted opening 894 in the handle wall 876 .
- the slotted opening 894 comprises a longitudinal channel 896 through the handle wall.
- the longitudinal channel 896 is seen to have a distal channel end 898 and a proximal channel end 900 .
- the slotted opening 894 also comprises a transverse channel 902 intersecting the longitudinal channel 896 at an intermediate location between the proximal channel end 898 and the distal channel end 900 , providing a “T” shaped opening.
- a single head suture anchoring device 904 is seen to be disposed within the single head delivery tool 860 , substantially within the needle cannulation 872 and distal to the distal piston end 884 .
- the single head anchoring device 904 comprises a suture head 906 and at least one collapse tail 908 extending proximally from the suture head 906 through the piston cannulation 888 .
- the single head anchoring device 904 can comprise a nonsliding or a sliding suture head.
- the suture head 904 is a nonsliding suture head that also comprises a distal suture loop 910 disposed at the distal end of the suture head 906 , and a releasable holding member 912 disposed proximally to the proximal piston end 886 , the releasable holding member 912 can be any type of releasable holding member disclosed hereinabove in association with the dual head delivery tool 530 .
- the releasable holding member 912 prevents the collapse tail 908 from sliding distally through the piston cannulation 888 . Further, with the releasable holding member 912 in place, proximally retracting the piston 882 also retracts the suture anchoring device 904 , along with the suture loop 910 , into the needle cannulation 872 without collapsing the suture head 906 to an anchoring knot. Upon release of the releasable holding member, the collapse tail 908 can slide distally through the piston cannulation 888 .
- FIG. 11 a through FIG. 11 i schematically illustrate an embodiment of surgical steps for a daisy-chaining procedure using the single head delivery tool 860 and the daisy-chaining embodiment of the single-head suture anchoring device 904 .
- the daisy-chaining procedure can be performed as part of an arthroscopic procedure or an open surgical procedure wherein a suture tail anchored to tissue is provided by earlier surgical steps.
- the following description of the procedure references FIG. 10 as well as FIG. 11 a through FIG. 11 i .
- FIG. 11 a through FIG. 11 i includes an illustration of a surgical step, in some of the figures accompanied by an illustration representing a position of the control member 892 in the substantially T-shaped slotted opening 894 as illustrated in FIG. 10 .
- FIG. 11 a illustrates a first step in the daisy-chaining procedure.
- An anchored suture tail 922 is seen to have been anchored at a first location 924 to tissue 926 having a first surface 928 and a second surface 930 .
- the anchored suture tail 922 is anchored to the tissue 926 by a first anchoring knot 932 according to the present invention.
- the anchored suture tail 922 is anchored to the tissue 926 by another type of suture anchoring device.
- the anchored suture tail 922 is seen to have been passed through the suture loop 910 of the single head anchoring device 904 disposed in the single head delivery tool 860 .
- the control member 892 is seen to be disposed in the transverse channel 902 of the slotted opening 894 .
- the control member 892 is seen to have been moved from the transverse channel 902 to the longitudinal channel 896 and to the proximal channel end 900 , retracting the single-head suture anchoring device 904 , including the distal suture loop 910 , into the distal end of the needle cannulation 872 .
- This retraction step provides retention of the anchored suture tail 922 to the single head delivery tool 860 .
- the needle 866 of the single head delivery tool 860 along with the retained, anchored suture tail 922 , is seen to have been passed distally through the tissue 926 at a second location 938 .
- the anchored suture tail 922 is seen to bridge the span of the tissue 926 between the first 924 and the second location 938 , to pass distally through the tissue 926 alongside the needle 866 , through the distal suture loop 910 (inside the needle cannulation 872 ) and return proximally through the tissue 926 to extend proximally as a tensioning tail 940 .
- FIG. 11 d in a fourth step, the control member 892 is seen to have been moved along the longitudinal channel 896 to the distal channel end 898 , thereby expelling the suture head 906 distally from the delivery needle 866 .
- FIG. 11 e in a fifth step, the collapse tail 908 is seen to have been tensioned 946 proximally, thereby collapsing the suture head 906 to a second anchoring knot 948 .
- the releasable holding member 912 is released in this step.
- the delivery needle 866 is seen to have been retracted from the tissue 926 , leaving the collapse tail 908 extending from the second anchoring knot 948 and through the piston cannulation 888 .
- the anchored suture tail 922 is seen to bridge the span of the tissue 926 between the first 932 and the second anchor knot 948 , passing through the tissue 926 at the first 924 and the second location 938 . Further, the tensioning tail 940 extends proximally through the tissue 926 from the second anchoring knot 948 .
- the single head delivery tool 860 is seen to have been removed entirely from the surgical site, leaving the collapse tail 908 and the tensioning tail 940 extending proximally from the second anchoring knot 948 and through the tissue 926 .
- Proximally tensioning the tensioning tail 940 transmits tension through the distal suture loop 910 (now part of the second anchoring knot 948 ) to the anchored suture tail 922 , thereby shortening the suture between the first 932 and the second anchoring knot 948 .
- the tissue 926 comprises a tear between the first 924 and the second location 938 , and tensioning 954 the tensioning tail 940 applies a closing force to the tear.
- a knot 958 is seen to have been tied between the tensioning tail 940 and the collapse tail 908 to prevent loosening of the tension applied to the tensioning tail 940 in the seventh step 952 .
- the knot 958 can be positioned adjacent the second anchoring knot 948 using a knot pusher or another known surgical technique.
- the collapse tail 908 and the tensioning tail 940 are seen to have been trimmed to or below the first tissue surface 928 .
- one or both of the tensioning tail 940 and the collapse tail 908 is left untrimmed, and is passed through a closed loop of suture extending distally from an additional suture head, to provide a starting point for additional daisy-chaining to other suture anchoring locations.
- FIG. 12 a through FIG. 12 e schematically illustrate an embodiment of an alternative delivery system and method for anchoring suture to tissue according to the present invention.
- the alternative delivery system is particularly useful for surgical procedures wherein delivery of a suture head to relatively hard tissue such as cortical bone is required, and for procedures wherein full distal extension of the suture head from a delivery needle is acceptable before collapsing the suture head to an anchoring knot.
- a suture anchoring device 963 is seen to be disposed in a cannulated delivery needle 964 having a longitudinal needle cannulation 966 .
- a longitudinally slidable, cannulated piston 968 having a longitudinal piston cannulation 970 is seen to be positioned within the needle cannulation 966 .
- the suture anchoring device 963 is a sliding type device comprising a suture head 972 having a distal head end 974 , a proximal head end 976 and two collapse tails 978 , 980 extending from the proximal head end 976 .
- the collapse tails 978 , 980 are seen to be disposed between an exterior surface of the piston 968 , and an interior surface of the delivery needle 964 .
- a pusher rod 982 having a distal fork 984 is seen to be disposed through the piston cannulation 970 and distally through or alongside the suture head 972 , to engage a portion of suture 986 from which the suture head 972 is configured, in proximity to the distal head end 974 .
- the delivery needle 964 is seen to be positioned in the entrance of an anchoring hole 988 prepared in tissue 990 . In the embodiment illustrated in FIG. 12 a through FIG.
- the tissue 990 is bone, the anchoring hole 988 penetrating through a cortical layer 992 and into cancellous bone 994 .
- the anchoring hole 988 can be prepared using any surgical drilling or other bone-penetrating method.
- the pusher rod 982 is seen to have been used to push the suture head 972 distally from the needle 964 into the anchoring hole 988 , with the piston 968 following the distal motion of the suture head 972 .
- the piston 968 is used in concert with the pusher rod 982 to push the suture head 972 from the needle 964 .
- the pusher rod 982 is seen to have been removed, leaving the suture head 972 positioned against the distal end of the piston 968 .
- the suture head 972 is seen to have been collapsed to an anchoring knot 1002 by proximally tensioning the two collapse tails 978 , 980 .
- the needle 964 and piston 968 therein are seen to have been removed proximally from the anchoring hole 988 , leaving the two collapse tails 978 , 980 anchored to the tissue 994 and available for further use in a surgical procedure.
- FIG. 13 illustrates a modified anchoring hole 1010 in bone 1012 wherein a cancellous portion 1014 of the anchoring hole 1010 is seen to have been dilated relative to a cortical portion 1016 of the anchoring hole 1010 , to accommodate deployment of an anchoring knot 1018 .
- Dilating the cancellous portion 1014 of the anchoring hole 1010 can be accomplished by any means, including but not limited to a curved cutting tool that can be inserted through the cortical portion 1016 of the anchoring hole 1010 , a tool that can be inserted into a drilled hole and deployed radially outward from an axis of insertion, a drill bit having a radially deployable cutting member near a distal end, and ultrasonic or other powered cutting tools.
- FIG. 14 a through FIG. 14 d schematically illustrate an alternative embodiment of a suture anchoring device according to the present invention, and its delivery to tissue, wherein a cannulated delivery needle is not required to deliver a suture head to tissue.
- a suture anchoring device 1020 is seen to comprise a nonsliding suture head 1022 that can comprise any type of nonsliding suture head disclosed herein.
- the suture head 1022 is seen to have a first head end 1024 and a second end 1026 .
- a collapse tail 1028 Extending from the first end 1024 is a collapse tail 1028 , and extending from the second end 1026 is a delivery suture tail 1030 terminated with a tissue-penetrating tool 1032 that in various embodiments is a suturing needle or a surgical guidewire.
- the delivery tail 1030 is not configured as a collapse tail, so tensioning the delivery tail 1030 with respect to the suture head 1022 does not collapse the suture head 1022 to an anchoring knot.
- the suture anchoring device 1020 is used in a surgical procedure performed from inside 1034 a patient's body, such as an arthroscopic procedure, to anchor suture to a first internal body tissue 1036 underlying the skin 1038 of the patient.
- the first internal tissue 1036 also underlies a second internal body tissue 1040 beneath the skin 1038 .
- the first internal tissue 1036 is a meniscus of a knee
- the second internal tissue 1040 is a joint capsule of the knee.
- FIG. 14 b illustrating a first surgical step
- the tissue-penetrating tool 1032 is seen to have been passed from inside 1034 the patient through the first body tissue 1036 , the second body tissue 1040 and the skin 1038 .
- the suture head 1022 has been pulled through the first body tissue 1036 , disposing the suture head 1022 between the first body tissue 1036 and the skin 1038 .
- the collapse tail 1028 and the delivery tail 1030 are seen to have both been tensioned with respect to the suture head 1022 , to collapse the suture head 1022 to an anchoring knot 1050 .
- the anchoring knot in a finishing step, is seen to have been anchored against the first body tissue by tensioning the collapse tail 1028 , and the delivery tail 1030 is seen to have been trimmed, leaving no suture protruding above the skin 1038 .
- the delivery tail 1030 anchored by the anchoring knot 1050 , is then available for further use in the surgical procedure, for connection to another tissue or implantable device (not illustrated in FIG. 14 a - FIG. 14 d ).
- the suture anchoring devices of the present invention disclosed hereinabove can be used to anchor suture to an intermediate implant that itself can be fixed to tissue.
- the intermediate implant can be any of a variety of implant types including but not limited to a suture anchor, a cannulated screw or rivet, and another implanted object such as a bone plate. Fixation of the intermediate implant to tissue can be by any known means including but not limited to interference, toggling, screw threads, expandable or extendable members, adhesives and cements.
- FIG. 15 a through FIG. 15 d illustrate in cross-section, an embodiment of a suture anchoring system and associated method incorporating a suture head that can be any type of suture head disclosed hereinabove, and an intermediate implant for fixation to tissue.
- a tissue-anchoring body 1060 is seen to be provided for fixation in a hole 1062 in tissue 1064 that in one embodiment is bone having a cortical layer 1066 and a cancellous layer 1068 .
- the tissue-anchoring body 1060 is seen to have a proximal end 1070 , a distal end 1072 and a cannulation 1074 extending therebetween.
- the cannulation 1074 has a substantially fixed cross-sectional dimension (diameter, if the cannulation has a circular cross section) along its length.
- the tissue-anchoring body 1060 is seen to further include one or more external fixation member 1076 for fixing the tissue-anchoring body 1060 in the hole 1062 . Any known method can be used for preparing the hole 1062 in the tissue 1064 and for fixing the anchoring body 1060 therein.
- the one or more fixation member 1076 comprises external screw threads on the anchoring body 1060 , for engagement with an inner wall of the hole 1062 .
- the anchoring body 1060 also includes a tool-engaging feature 1078 for releasable connection of a complementary insertion tool 1080 to the anchoring body 1060 , for rotationally threading the anchoring body 1060 into the hole 1062 .
- the tool-engaging feature 1078 can comprise a noncircular internal cross-section of the cannulation 1074 along at least a portion of its length between the proximal end 1070 and the distal end 1072 .
- the noncircular cross section can be any type of cross section effective for rotational engagement, such as a hexagonal internal cross-section for receiving the insertion tool 1080 , or other configurations including but not limited to square, star-shaped and other screwdriver-type fittings and the like.
- the anchoring body 1060 comprises a self-drilling screw that can be fixed into the tissue 1064 without provision of a pre-drilled hole.
- FIG. 15 b illustrates the tissue-anchoring body 1060 fixed to the tissue 1064 .
- a delivery tool 1082 for delivering a suture head 1084 comprising one or more proximally extending suture tail 1086 is seen to have been disposed at least partially through the cannulation 1074 from the proximal end 1070 toward the distal end 1072 of the anchoring body 1060 .
- the delivery tool 1082 preferably includes a stop element 1088 that determines a maximum insertion depth of the delivery tool 1082 into the cannulation 1074 .
- the suture head 1084 is seen to have been delivered distally beyond the distal end 1072 of the cannulation 1074 , and collapsed to an anchoring knot 1090 that has a larger cross sectional dimension than that of the cannulation 1074 , to resist pullout of the anchoring knot 1090 proximally through the cannulation 1074 when the one or more suture tail 1086 is tensioned.
- the delivery tool 1082 is also seen in FIG. 15 d to have been removed from the cannulation 1074 .
- the insertion tool 1080 is removed from the anchoring body 1060 following fixation of the anchoring body 1060 to the tissue 1064 , as illustrated in FIG. 15 b , or left connected to the anchoring body 1060 following fixation.
- the insertion tool 1080 is cannulated for receiving the delivery tool 1082 therethrough and to the cannulation 1074 .
- the insertion tool 1080 also functions as a guide for assisting a surgeon in locating the cannulation 1074 for deploying the suture head 1084 .
- FIG. 16 a through FIG. 16 d Another embodiment of a suture anchoring system and associated method incorporating a suture head and an intermediate implant for fixation to tissue is illustrated in FIG. 16 a through FIG. 16 d .
- the embodiment of FIG. 16 a through FIG. 16 d resembles the embodiment of FIG. 15 a through FIG. 15 d , except that, in the embodiment of FIG. 16 a through FIG. 16 d , an anchoring knot is contained substantially within an intermediate implant after deployment, rather than distal to the intermediate implant.
- a knot-holding anchoring body 1094 for fixation in the hole 1062 in the tissue 1064 is provided.
- the knot-holding anchoring body 1094 is seen to have a proximal end 1096 , a distal end 1098 and a variable cross-section cannulation 1100 extending therebetween.
- the knot-holding anchoring body 1094 is seen to resemble the tissue anchoring body 1060 of FIG. 15 a through FIG. 15 d , except that the variable cross-section cannulation 1100 is seen to include an enlarged diameter portion 1102 distally spaced from the proximal end 1096 .
- variable cross-section cannulation is stepped 1104 in cross-section along its length, having a greater cross-section at the distal end 1098 than at a proximal end 1096 .
- variable cross-section cannulation 1094 is substantially closed at the distal end 1098 of the knot-holding anchoring body 1094 .
- FIG. 16 b illustrates the knot-holding anchoring body 1094 fixed to the tissue 1064 .
- the suture head 1084 is seen to be disposed in the delivery tool 1084 as described in association with FIG. 15 c , but, as illustrated in FIG. 16 d , delivered into the enlarged portion 1102 of the variable cannulation 1100 for collapse to an anchoring knot 1106 disposed substantially within the variable cannulation.
- the anchoring knot 1106 conforms to an internal cross section of the enlarged portion 1102 of the variable cannulation 1100 .
- Hybrid embodiments such as those of FIG. 15 a through FIG. 16 d , comprising both a suture head and an intermediate implant, are useful, for example, in surgical procedures where a hole or a slot in the intermediate implant is or can be provided for anchoring suture in one or more location on the implant.
- one or more suture leg extends from a first anchoring knot and proximally through the hole or cannulation.
- a cross-sectional dimension of the preformed hole or cannulation is sized to permit passage of a delivery tool for a second anchoring device through the hole or cannulation, alongside the one or more suture leg.
- Suture anchoring devices have many advantages, including but not limited to advantages associated with their structure and materials of construction, versatility of application and delivery, reduced surgical trauma, fixation strength, and failure mode.
- suture-anchoring devices advantageously made substantially from suture present no materials compatibility issues between the materials used for an anchor body and suture connected thereto.
- the present invention can provide suture anchoring devices and associated sutures constructed from a single continuous length of suture, advantageously eliminating all interfaces among anchor components.
- suture-anchoring devices made substantially from suture have no sharp edges or corners that can damage the tissue in which they are implanted.
- the materials of construction can be selected from among a broad variety of available suture materials, including materials that can provide one or more of great mechanical strength, excellent tissue compatibility, controlled bioabsorbability and tissue ingrowth, and other desirable properties suitable for a surgical repair procedure.
- mechanical and chemical treatment of sutures for controlling lubricity, knotting, or chemical elution is well known in this art and readily applied to entire suture-anchoring devices of the present invention, or to sections thereof by treating only a portion of the suture used to construct a suture anchoring device.
- knotted anchoring configurations themselves provided by the present invention are relatively open structures that can encourage tissue ingrowth for enhanced healing.
- Suture anchoring devices are advantageously delivered to tissue via a cannulated delivery needle having a diameter only a few times the diameter of the suture from which the anchoring device is constructed, thereby minimizing surgical trauma associated with the delivery method.
- Delivery can be to a space behind a tissue wall, or into bulk tissue, for example, into cartilage or into cancellous bone behind a small-diameter penetration through overlying cortical bone.
- the cross-sectional size of a deployed anchoring knot in tissue is determined primarily by the length of a suture head disposed in the delivery needle, so a wide range of anchor knot sizes, and therefore deployed retention strengths, can be delivered using a given delivery needle diameter.
- This feature enables the fixation strength of a repair to be tailored for a specific surgical procedure, up to the failure strength of the suture material, and without such issues as cheese-wiring of anchor materials, or breakage of suture at sharp corners of an anchor body. Also advantageously, if a repair performed using anchoring devices according to the present invention does fail, no potentially injurious sharp-edged or pointed fragments from a failed anchor body are produced.
- Suture anchoring devices are particularly advantageous for performing minimally invasive repairs of damaged tissue, such as repairs of soft tissue tears or separations from underlying bone.
- a minimally invasive repair of a partial thickness a rotator cuff tear could be performed by passing a small diameter delivery needle containing one or more suture head through tissue of the damaged rotator cuff and into underlying bone of the humerus, for anchoring suture in the bone, for reapproximating the rotator cuff tissue to the bone with minimum surgical trauma.
- the delivery needle can be shaped to include one or more bend or a curve along its length, for optimizing access to a surgical site and further minimizing surgical trauma.
- Exemplary shapes of the delivery needle can include a substantially 180 degree U-turn along the needle, as well as any other angle turn, and a helical (corkscrew-shaped) delivery needle.
- the suture head can be collapsed to an anchoring knot as it is being expelled from the needle, thereby minimizing the penetration depth into or through tissue required for deployment. This feature is particularly advantageous, for example, where anchoring of suture is required to a small bone, or within a shallow space behind a tissue wall. For instance, FIG.
- FIG. 1 b shows the suture head 102 protruding in full length beyond the needle 116 .
- the suture tail 112 while forcing the suture head 102 out with the piston 128 rather than the suture head 102 protruding in full length, it just expands into the anchoring knot 136 at the needle distal end 120 .
- suture anchoring devices disclosed herein include either or both of fixed and slidable coupling between an anchoring knot and suture.
- a plurality of suture-coupled anchoring devices can be delivered from a single delivery needle.
- the plurality of anchoring devices in a single delivery needle can include more than one type of anchoring device.
- an adhesive or cement can be injected with the anchoring device, to additionally stabilize a repair.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Rheumatology (AREA)
- Surgical Instruments (AREA)
Abstract
Description
- The present invention relates in general to devices, systems and methods for repairing and anchoring damaged tissue, and more particularly, to devices, systems and methods for anchoring suture to tissue.
- Injuries to tissue such as cartilage, skin, muscle, bone, tendon and ligament, frequently require surgical intervention to repair the damage and facilitate healing. Surgical procedures to repair tissue damage are often performed using sutures connected to one or more anchoring device (suture anchor) implanted in or adjacent to the damaged tissue. The sutures can also be passed through or around the tissue according to a variety of surgical techniques to secure the repair. The sutures can also interconnect two or more anchors used to perform the repair. Suture anchors have been fabricated with bodies formed from a variety of materials including nonabsorbable materials such as metals and durable polymers, as well as bioabsorbable materials such as absorbable polymers, bioceramics, absorbable composites and processed bone.
- Anchors can be designed for fixation with respect to tissue using external screw threads on an anchor body, an expandable body, toggling action, extendable components such as barbs, or other mechanical retention means. Sutures can be connected through or around suture anchors in a fixed or a sliding manner, for example, using eyelets or other passages in an anchor body, and can be secured using stationary or sliding knots, interference among anchor components, interference between an anchor and surrounding tissue, or other means. Some suture anchors are designed for suture to slide unidirectional through or around the anchor, enabling a surgical repair to be tightened by tensioning a portion of the suture with respect to the anchor. Among their many surgical applications, suture anchors are used with sutures to reattach damaged tendons or ligaments to bone, to tighten compromised tissue surrounding articulating joints, and to repair tears in cartilage, such as torn meniscal cartilage in a knee. In some applications, two or more anchors joined by an adjustable length of suture enable a tissue tear to be cinched closed, or compromised tissue to be stabilized.
- Of great importance in suture anchor design is maximizing the retention strength of the anchor in tissue, to minimize the risk of anchor breakage or pullout from tissue when an attached suture is tensioned with respect to the anchor. One common approach to maximizing anchor retention strength is to use physically larger anchors than might be preferable to minimize surgical trauma caused by the procedure used to implant the anchor. Not only does the implantation of a larger anchor generally require a larger and therefore more traumatic surgical incision than would be required to implant a smaller anchor, but the tools required to implant or deploy a larger anchor may also be correspondingly larger. Compounding this issue, the process of deploying an anchor in tissue can require both substantially vertical access to the tissue repair site, and significantly deeper penetration into or through the tissue than the depth required to retain the anchor after deployment in tissue. In addition, many surgical anchors have sharp edges that can cause tissue damage when implanted in a patient. Addressing these concerns is particularly important in the development of minimally invasive surgeries such as arthroscopic procedures that restrict access to an operative site, at least in part to reduce surgical trauma relative to open surgical procedures.
- There is a preference among some surgeons for using non-metallic suture anchors rather than metallic suture anchors. While some nonmetallic anchors can provide advantages over metallic anchors with respect to bioabsorbability or radiolucence, many nonmetallic anchors provide significantly lower mechanical strength than metallic anchors, increasing the potential for mechanical failure of the surgical repair during or post-surgery. For example, suture may cut through relatively soft materials used to fabricate a nonmetallic anchor, a process often called “cheese-wiring.” With metallic suture anchors, the interface between suture and the anchor must also be carefully designed to protect attached suture from breakage. For example, a metallic suture anchor may require precision polishing to minimize suture failure where suture contacts the much harder metal. With any suture anchor, sharp bends of suture about anchor components are well-known stress points that can lead to failure of a surgical repair. Post-surgical failure of an anchor-based surgical repair during the healing period is of particular concern because uncontrolled fragments of a failed anchor have the potential to cause injury to the patient.
- Accordingly, there remains a need for improved suture anchoring devices, systems and methods for repairing damaged tissue that overcome the limitations and disadvantages of known suture anchors. A need also exists for suture anchors, deployment tools and methods that minimize the surgical trauma associated with the implantation of an anchor of any given size.
- The present invention generally provides devices, systems and methods for anchoring suture to tissue. One aspect of the present invention is a method for anchoring a suture length to human tissue. The method comprises the steps of providing a preformed knot configuration to a first portion of the suture length, positioning the preformed knot configuration into an opening in a portion of the human tissue, and expanding the preformed knot configuration in at least one physical dimension to form an anchoring knot, so as to engage the anchoring knot against the tissue. In one embodiment, the preformed knot configuration is reduced in length and increased in a cross-sectional dimension when reconfigured to form the anchoring knot. The anchoring knot can be formed behind a tissue wall, or within bulk tissue, which can be soft tissue or bone.
- The preformed knot configuration can be formed from a single line of suture or from joined lines of suture that can be of a single structure and material, or of different structures and materials. In various embodiments, the preformed suture configuration is formed by intertwining portions of suture using any of a variety of methods including, but not limited to chain-knotting, braiding and crocheting. In an embodiment, the step of reconfiguring the preformed knot configuration into an anchoring knot includes placing an abutment against the preformed knot configuration and moving the suture length relative to the abutment to cause the preformed knot configuration to bunch up and increase in cross sectional area as the anchoring knot.
- The preformed knot configuration can be delivered to tissue through an inserter tube. In an embodiment, the inserter tube is passed though a tissue wall, and the anchoring knot is formed behind the tissue wall. In one embodiment, the preformed knot configuration does not protrude more than 5 mm beyond the wall before fully forming the anchoring knot. In another embodiment, the diameter of the anchoring knot is at least twice the diameter of the inserter tube.
- Another aspect of the present invention is a suture unit for anchoring in human tissue. The suture unit includes a first preformed knot configuration along a portion of a length of suture. The first preformed knot configuration has a maximum diameter along the suture length and is reconfigurable into a first anchoring knot having a minimum diameter that is at least five times larger than the first preformed knot configuration maximum diameter. The first preformed knot configuration can be formed from a single line of suture or from joined lines of suture that can be of a single structure and material, or of different structures and materials. In various embodiments, the preformed suture configuration is formed by intertwining portions of suture, using methods including, but not limited to chain-knotting, braiding and crocheting.
- In an embodiment, the first preformed knot configuration includes a portion of suture formed into a loop closed with a sliding knot that in one embodiment is positioned within the first preformed knot configuration. The suture unit can include a second preformed knot configuration expandable into a second anchoring knot.
- The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
-
FIG. 1 a throughFIG. 1 d illustrate an embodiment of a suture-anchoring device and its deployment according to the present invention. -
FIG. 2 a throughFIG. 2 d illustrate a nonsliding embodiment of a suture fixation device according to the present invention comprising a twisted braid suture head. -
FIG. 3 a throughFIG. 3 c illustrate nonsliding embodiments of suture fixation devices according to the present invention comprising crocheted suture heads. -
FIG. 4 a throughFIG. 4 d illustrate sliding embodiments of suture anchoring devices according to the present invention. -
FIG. 5 a throughFIG. 5 d illustrate embodiments of suture anchoring devices according to the present invention comprising interpenetrating suture. -
FIG. 6 a andFIG. 6 b illustrate an embodiment of a suture anchoring device applicable to repairing a meniscus in a knee according to the present invention. -
FIG. 7 a andFIG. 7 b illustrate an embodiment of a delivery tool of the present invention that can be used to deliver the anchoring device illustrated inFIG. 6 a andFIG. 6 b to tissue. -
FIG. 8 a andFIG. 8 b illustrate an embodiment of a delivery tool of the present invention including a curved delivery needle. -
FIG. 9 a throughFIG. 9 k illustrate an embodiment of a surgical repair procedure of the present invention, for repairing a torn meniscus in a knee. -
FIG. 10 a andFIG. 10 b illustrate an embodiment of a delivery tool of the present invention for single-location anchoring and for daisy-chaining anchoring locations. -
FIG. 11 a throughFIG. 11 i illustrate an embodiment of a daisy-chaining anchoring procedure of the present invention. -
FIG. 12 a throughFIG. 12 e illustrate an embodiment of delivery of suture anchoring devices of the present invention into hard tissue. -
FIG. 13 illustrates an embodiment of a sub-cortically dilated hole in a bone for receiving a suture anchoring device of the present invention. -
FIG. 14 a throughFIG. 14 d illustrate an alternative embodiment of a delivery device of the present invention. -
FIG. 15 a throughFIG. 15 d illustrate an embodiment of a suture anchoring system of the present invention wherein a suture head is used in conjunction with an intermediate anchoring implant. -
FIG. 16 a throughFIG. 16 d illustrate another embodiment of an anchoring system of the present invention wherein a suture head is deployed internally to an intermediate anchoring implant. - Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices, systems and methods disclosed herein. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention. It should be noted that the figures are generally schematic and not drawn to scale, and are intended only to facilitate the description of specific embodiments of the invention.
- The present invention generally provides devices, systems and methods for anchoring suture to tissue. The term “tissue” is used herein to refer to any natural body tissue including, but not limited to cartilage, skin, muscle, bone, tendon, ligament and organs, as well as to prosthetic materials such as grafts or other prosthetics that can be repaired or attached to natural body tissues with sutures and anchoring devices. Embodiments of suture anchoring devices fabricated substantially from surgical suture or any elongated, thread-like materials that can be used as medical devices (hereinafter, “suture”) are disclosed herein. The suture can comprise a single filament or a plurality of interwoven filaments, and can have any cross-sectional shape including, but not limited to a substantially circular cross section, and a flattened ribbon or tape-like cross section. Further, the suture can be non-absorbable, bioabsorbable, or partially bioabsorbable. Without deviating from the intent or scope of the invention, the suture material can be mechanically or chemically modified, treated or coated to enhance lubricity or knot-holding ability, to elute a medicament, or for any combination of the aforementioned or other therapeutic purposes. Further, although various embodiments of anchoring devices in accordance with the invention can be constructed entirely of suture, additional components such as clips or adhesives can be included without deviating from the intent or scope of the invention.
- An anchoring device according to the present invention generally comprises one or more segment of suture (hereinafter, suture tail) extending from an anchoring member having a longitudinally elongated, small cross section initial configuration (hereinafter, a suture head). Upon deployment, the suture head is reconfigured (collapsed) to a longitudinally compressed configuration (an anchoring knot) of correspondingly larger cross-section than the suture head. That is, the anchoring knot has a larger cross sectional area and a larger average cross sectional dimension (hereinafter, cross-sectional dimension) than the corresponding dimensions of the suture head. In some embodiments, for delivery to tissue, the suture anchoring device is disposed in a cannulated delivery needle having an outer diameter substantially smaller than the cross-sectional dimension of the anchoring knot. In general, collapsing a suture head to an anchoring knot is accomplished by tensioning a specific one or more (collapse tail) of the one or more suture tail, with respect to the suture head.
-
FIG. 1 a schematically illustrates an embodiment of a suture-anchoringdevice 100 according to the present invention. Thesuture anchoring device 100, illustrated undeployed inFIG. 1 a, comprises asuture head 102 having a firsthead end 104, asecond head end 106, ahead length 108 therebetween and an undeployedcross-sectional dimension 110 that is smaller than thehead length 108. Afirst suture tail 112 is seen to extend substantially from thefirst head end 104. In an embodiment, asecond suture tail 114 extends substantially from thesecond head end 106. In a further embodiment, thesecond suture tail 114 comprises a closed loop of suture extending from thesecond head end 106. In other embodiments, two or more suture tails extend from one or both of the first 104 and thesecond head end 106. - The
suture head 102 comprises a longitudinally extended, preformed knot configuration, by which we mean any braided, crocheted, woven, knotted or otherwise configured section of suture that, for deployment and fixation with respect to tissue, can be readily collapsed into a longitudinally compressed, expanded cross-section form referred to herein as an anchoring knot. - The
suture head 102 is seen to be disposed in a cannulateddelivery needle 116 for delivery into or throughtissue 118. Thedelivery needle 116 has adistal delivery end 120, anouter diameter 122 and aninner diameter 124. Further, thedelivery needle 116 can be straight or curved along its length. In an embodiment, thedelivery end 120 includes a tissue-penetratingpoint 126. In another embodiment (not illustrated), thedelivery end 120 is not pointed. Apiston 128 having alongitudinal piston cannulation 130 therethrough is seen to be slidingly disposed within thedelivery needle 116, proximal to thesuture head 102. Thefirst suture tail 112 is seen to pass proximally from thesuture head 102 through thepiston cannulation 130. - Now referring to
FIG. 1 b, in one embodiment, thesuture head 102 is delivered from thedelivery needle 116 to thetissue 118 by pushing thepiston 128 distally against thesuture head 102 to expel thesuture head 102 from thedelivery needle 116. Thepiston 128 is seen to abut the expelledsuture head 102. In an embodiment, thepiston 128 is coupled to a proximal handle (not illustrated) that provides control of the longitudinal position of thepiston 128 within thedelivery needle 116. In an alternate embodiment, thesuture head 102 is delivered from thedelivery needle 116 by distally pulling thesecond suture tail 114. In one embodiment, theneedle 116 is straight. In another embodiment, theneedle 116 is curved and thepiston 128 is flexible so as to enable thepiston 128 to slide along the curve for delivery of thesuture head 102 from theneedle 116. As thesuture head 102 substantially comprises suture, it is also flexible for sliding through a curved needle. - Now referring to
FIG. 1 c, following or concurrently with delivery of thesuture head 102 from theneedle 116, thesuture head 102 is collapsed to form ananchoring knot 136. In an embodiment, thesuture head 102 is collapsed to the anchoringknot 136 by tensioning 138 the first suture tail 112 (a collapse tail) with respect to thesuture head 102 after thesuture head 102 has been pushed entirely out of thedistal end 120 of theneedle 116 by thepiston 128. Thepiston 128 abutting thesuture head 102 provides a counter force to the tensioning 138 of thefirst suture tail 112 with respect to thesuture head 102, to collapse thesuture head 102 to the anchoringknot 136. - The term “collapse tail” is used herein to describe any suture tail that, when tensioned with respect to a suture head, can be used to collapse the suture head to an anchoring knot. The anchoring
knot 136 has aknot length 140 that is shorter than thehead length 108, and a correspondingly increasedcross section 142, determined substantially by the volume of suture originally comprising thesuture head 102. - In another embodiment, the
first suture tail 112 is tensioned concurrently with thesuture head 102 being expelled from thedistal end 120 of theneedle 116, collapsing thesuture head 102 to the anchoringknot 136 as it emerges from theneedle 116. In this embodiment, thesuture head 102 does not extend distally from thedelivery needle 116 thefull head length 108 during deployment, but instead extends only theknot length 140. This shallower extension can provide deployment of theanchoring device 100 that minimizes surgical trauma to tissue positioned distally beyond, but in proximity to the distal end of the delivery needle. -
FIG. 1 d illustrates a fully deployedanchoring device 144, wherein theneedle 116 is seen to have been removed, and the anchoringknot 136 is anchored with respect to thetissue 118, leaving thefirst suture tail 112 available for connection to tissue or to another anchoring device, or for any other surgical step requiring a suture that is anchored to tissue. According to the requirements of a particular surgical repair, the anchoringknot 136 can be deployed behind a tissue wall as illustrated inFIG. 1 d, or within bulk tissue, for example, within a bone for anchoring suture to the bone. In other embodiments, two or more suture heads, interconnected by suture, are disposed in a needle for surgical procedures requiring two or more tissue anchoring points. - The anchoring
knot 136 has aknot length 140 that is less than thehead length 108, and a deployed crosssectional dimension 142 that is correspondingly greater than the undeployed crosssectional dimension 110, and greater than theouter diameter 122 of theneedle 116. In an embodiment, the anchoringknot 136 is amorphous, that is, having an incompletely predetermined external shape following collapse from thesuture head 102 to the anchoringknot 136. In general, anchoring knots formed from suture heads according to the various embodiments of the present invention are amorphous. Although neither thesuture head 102 nor the anchoringknot 136 have a completely predetermined shape, either can be reasonably described as having a length and a diameter transverse to the length, the diameter approximately defined by the average cross-sectional dimension transverse to the length. - By way of nonlimiting example, in one embodiment, the
head length 108 is between approximately ten and fifty times the undeployedcross-sectional dimension 110, and the deployedcross-sectional dimension 142 is between three and ten times the undeployedcross-sectional dimension 110. The suture-anchoringdevice 100 can be fabricated substantially from a single continuous length of suture, or from a plurality of coupled lengths of suture. The plurality of coupled lengths can include a single type of suture or a combination of suture types and sizes. Further, the one or more suture tail can be fixedly coupled to the anchoring knot, or slidably coupled therethrough. In one embodiment, theinner diameter 124 of theneedle 116 is less than about six times a diameter of the suture material from which the suture head is configured. In another embodiment, theinner diameter 124 of theneedle 116 is less than about four times a diameter of the suture material from which the suture head is configured. - In an anchoring device according to the present invention, the design of the suture head substantially determines the overall design and procedural details of delivery and deployment. The design of the suture head also determines the pull-out strength of the deployed anchoring knot, and the anchor density, that is, the mass of suture material in an anchoring knot having a given cross-sectional dimension. Many anchoring device designs are possible within the scope of the present invention. For nonlimiting descriptive purposes herein, these designs are grouped into two general categories respectively called non-sliding embodiments, wherein all suture tails extending from a fully deployed anchoring knot are fixed thereto substantially without sliding through the knot, and sliding embodiments, wherein at least one length of suture slidingly passes through the fully deployed anchoring knot. Sliding embodiments are advantageous for some surgical applications, for example, where it is desirable to tension suture between a deployed anchoring member and attached tissue, to draw two or more anchoring devices together to close a tissue tear, or to gather together intervening tissue between anchoring devices.
- In an illustrative sliding embodiment, the anchoring device comprises at least a first length of suture and a second length of suture. The first length of suture generally comprises the bulk of a suture head (and, following deployment, a corresponding anchoring knot). The second length of suture comprises two suture tails and is slidable through the anchoring knot by tensioning one or the other of the two tails individually with respect to the anchoring knot. The sliding embodiment can further include additional sliding sutures having corresponding pairs of suture tails. Sliding embodiments can also include one or more fixed suture tail that can comprise a portion of the first length of suture, or an additional length of suture fixedly connected, for example, tied, to the first length of suture. Further, depending on the specific design of the suture head, one or more suture tail can comprise one or both of a collapse tail and a sliding tail.
- Nonsliding embodiments can comprise a single length of suture or a plurality of suture lengths that are fixedly joined together, for example, by one or more knot. Nonsliding embodiments include a suture head from which one or more suture tail extends, at least one of the one or more suture tail comprising a collapse tail.
- A suture head according to the present invention can comprise any preformed knot configuration that can be collapsed from a longitudinally extended form to a longitudinally compressed, increased cross section anchoring knot. In various embodiments, the suture head includes a plurality of openings comprising loops, penetrations or other openings formed along a first longitudinal section of suture. A second longitudinal section of suture comprising a collapse tail is woven through two or more of the plurality of the openings. One or more suture tails extends from the suture head, at least one of the one or more suture tails comprising the collapse tail. In one embodiment, the first section of suture, the second section of suture and the one or more suture tail comprise a single continuous length of suture. In another embodiment, the first section of suture, the second section of suture and the one or more suture tail comprise two or more joined lengths of suture.
- Anchoring devices of the present invention can include one or more of a variety of types of suture heads, and can be fabricated using a variety of methods. One type of suture head comprises a braided section of suture that is collapsible to an anchoring knot. Any type of suture braiding can be used to configure the suture head. An embodiment of a nonsliding, twisted braid suture-anchoring device is schematically illustrated in
FIG. 2 a andFIG. 2 b.FIG. 2 a illustrates afirst configuration step 200, wherein a length ofsuture 202 is seen to have been formed into a startingloop 204 having a firsthead end 206, asecond head end 208 and ahead length 210 therebetween. Asuture tail 212 extends from thesecond head end 208.FIG. 2 b illustrates a configuredsuture head 214. As can be seen inFIG. 2 b, theloop 204 has been repetitively twisted to provide a plurality ofopenings 216 along thehead length 210. Further, thesuture tail 212 is seen to have been woven through the plurality ofopenings 216 from thesecond head end 208 to thefirst head end 206, and extends from thefirst head end 206, where it comprises a collapse tail. - It should be noted that in
FIG. 2 b, as well as other figures herein detailing suture head configurations, the suture heads are generally illustrated in an expanded schematic form to support description of routing of suture therethrough. Any suture head disclosed herein can be readily compressed in cross section, for example, for disposition within a cannulated delivery needle, as illustrated inFIG. 1 a. By way of example,FIG. 2 c illustrates thesuture head 214 in a compressed cross section form 218, as for disposition in a delivery needle. Thesuture head 214 can be collapsed to ananchoring knot 220, as illustrated inFIG. 2 d, by tensioning the suture tail 212 (collapse tail) with respect to thesuture head 214. - By tensioning the
first suture tail 212 with respect to thesuture head 214, we mean tensioning (pulling) thefirst suture tail 212 away from thesuture head 214, so that the portion of thefirst suture tail 212 that is woven through the plurality ofopenings 216 is pulled further through the plurality ofopenings 216 and through thefirst head end 206, thereby gathering or bunching the twisted suture along thehead length 210 into the anchoringknot 220. For tensioning 222 thefirst suture tail 212 with respect to thesuture head 214, an abutment to the first head end, for example, thepiston 128 ofFIG. 1 is required to hold the suture head in position for collapsing to the anchoringknot 220. In some embodiments wherein a suture head is embedded in tissue or trapped behind a tissue wall before tensioning a collapse tail, friction with the tissue can also retain the suture head during collapse to an anchoring knot. - Any type and diameter of suture, and any number of
openings 216 for braiding or otherwise passing suture therethrough, can be used to configure a suture head according to the present invention. A larger number of openings generally provides a longer suture head and, upon deployment, an anchoring knot having a larger cross sectional dimension, thereby providing greater fixation strength of the anchoring knot with respect to tissue. In one embodiment, a 20 mm long suture head comprises between fifteen and thirty-five openings through which suture can be woven. In another embodiment, the plurality of openings is between twenty and thirty openings. In yet another embodiment, the suture head is approximately 25 millimeters (mm) in length, and upon deployment in tissue, the suture head collapses to a substantially amorphous anchoring knot approximately five mm in diameter. - In one test embodiment, a suture head approximately 20 mm long was configured from partially absorbable, polyethylene-containing braided suture approximately 0.5 millimeters (mm) in diameter (ORTHOCORD™ Orthopaedic Suture from DePuy Mitek, Raynham, Mass.). Deployed through a 2-mm diameter hole into the cancellous layer of artificial bone having a 3-mm thick, 55-durometer cortex, the pullout strength of the resulting anchoring knot was approximately 45 pounds. Deployment of a similarly configured anchoring device through a 2-mm diameter hole in artificial bone having a 3-mm thick, 35-durometer cortex provided a pullout strength of approximately 22 pounds.
- A person skilled in the art will appreciate that, within the scope of the present invention, many different methods can be used to configure a suture head having a longitudinally extended configuration that is collapsible to an anchoring knot. Braids, for example, can be formed by a variety of methods and with any number of suture sections braided together, and a suture head configured to include any braiding pattern is within the scope of the present invention. Further, braiding comprises only one of a variety of methods for configuring a suture head according to the present invention. Other methods for configuring a suture head can be adapted, for example, from other textile arts such as crocheting and weaving.
- Another anchoring device of the present invention includes a suture head configured using a chain of suture loops. The chain of loops can comprise a plurality of independent suture loops, a physically connected chain of discrete loops, or a plurality of loops formed along a continuous length of suture using known textile arts such as crocheting, where each of the plurality of loops in a chain is formed by pulling a section of the suture through a previously formed loop in the suture. The plurality of loops provides a corresponding plurality of openings through which suture can be woven. Nonsliding embodiments of suture anchoring devices comprising suture heads configured using crocheted suture are schematically illustrated in
FIG. 3 a throughFIG. 3 c.FIG. 3 a illustrates acrochet configuration step 230 wherein a length ofsuture 232 has been crocheted to define a plurality ofopenings 234 along a crochetedsection 236 having a firstcrocheted end 238 and a secondcrocheted end 240. Afirst suture tail 242 extends from the firstcrocheted end 238 and asecond suture tail 244 extends from the secondcrocheted end 240. -
FIG. 3 b illustrates afirst embodiment 250 of a crocheted suture-anchoring device. It comprises asuture head 252 wherein thefirst suture tail 242 is seen to weave through one or more of the plurality ofopenings 234 along the crochetedsection 236 from the firstcrocheted end 238 to the secondcrocheted end 240, and extends from the secondcrocheted end 240. Thesuture head 250 can be collapsed to an anchoring knot by tensioning the first suture tail 242 (collapse tail) with respect to thesuture head 252. -
FIG. 3 c illustrates asecond embodiment 260 of a crocheted suture-anchoring device. Thesecond embodiment 260 resembles thefirst embodiment 250, with the addition that in thesecond embodiment 260, after being woven from the first 238 to the secondcrocheted end 240, thefirst suture tail 242 is returned through one or more of the plurality ofopenings 234 from the secondcrocheted end 240 to the firstcrocheted end 238, to extend from the firstcrocheted end 238. Thesuture head 262 can be collapsed to an anchoring knot by tensioning the first suture tail 242 (collapse tail) with respect to thesuture head 262. - It should be appreciated that not all suture tails are collapse tails. Referring to
FIG. 3 b andFIG. 3 c, in either the first 250 or thesecond embodiment 260, thesecond suture tail 244 is directly connected to and extends from the second crocheted end, and tensioning thesecond suture tail 244 with respect to therespective suture head 252, 262 (providing an abutment against secondcrocheted end 240 does not collapse the respective suture head to an anchoring knot. Thus thesecond suture tail 244 can be used, for example, to pull therespective suture head -
FIG. 4 a throughFIG. 4 d illustrate sliding embodiments of suture anchoring devices according to the present invention.FIG. 4 a illustrates a sliding embodiment of a twisted ring suture-anchoringdevice 300. The twisted ring suture-anchoringdevice 300 comprises asuture ring 302 that is a closed ring of suture repetitively twisted to form a plurality ofopenings 304 between afirst twist end 306 and asecond twist end 308. A length ofsuture 310 having afirst suture tail 312 and asecond suture tail 314 is woven through the plurality ofopenings 304 between thefirst twist end 306 and thesecond twist end 308, and returning through at least one of the plurality ofopenings 304 near thefirst twist end 306, to configure asuture head 316 having both the first 312 and thesecond suture tail 314 extending from thefirst twist end 306. Thesuture head 316 can be collapsed to an anchoring knot by simultaneous tensioning of the first 312 and thesecond suture tail 314 with respect to thesuture head 316. Thus the first 312 and thesecond suture tail 314 comprise collapse tails when tensioned simultaneously with respect to thesuture head 316. As can be seen inFIG. 4 a, the length ofsuture 310 is not fixedly connected to thesuture ring 302, but woven therethrough to preserve slidability of the length ofsuture 310 through the anchoring knot. The length ofsuture 310 can slide through the anchoring knot by individually tensioning either the first 312 or thesecond suture tail 314 respectively, with respect to the anchoring knot. - A suture ring used to configure a suture head according to the present invention can comprise suture formed as a continuous ring of suture material, or a length of suture closed to form the ring. Any method of closing the length of suture to a ring can be used, including but not limited to knotting, welding, gluing, or crimping with or without a binding clamp or other joining member. Further, the suture ring can include a plurality of substantially parallel strands of suture about its circumference, braided, crocheted, or otherwise interlocked suture. In an embodiment, the suture ring comprises a continuous ring of suture having a first circumference, that is doubled over to form a doubled suture ring having a second circumference that is substantially half the first circumference.
-
FIG. 4 b illustrates a sliding embodiment of a suture-chain suture-anchoringdevice 322. The suture-chain suture-anchoringdevice 322 comprises a connected chain of suture rings 324 defining a plurality ofopenings 326 between afirst chain end 328 and asecond chain end 330. A length ofsuture 332 having afirst suture tail 334 and asecond suture tail 336 is woven through the plurality ofopenings 326 between thefirst chain end 328 and thesecond chain end 330, then returning through at least one of the plurality ofopenings 326 near thefirst chain end 328, to configure asuture head 338 having both the first 334 and thesecond suture tail 336 extending from thefirst chain end 328. Thesuture head 338 can be collapsed to an anchoring knot by simultaneous tensioning of the first 334 and thesecond suture tail 336 with respect to thesuture head 338. Thus the first 334 and thesecond suture tail 336 comprise collapse tails when tensioned simultaneously. As can be seen inFIG. 4 b, the length ofsuture 332 is not fixedly connected to the chain of suture rings 324, but woven therethrough to preserve slidability of the length ofsuture 332 through the anchoring knot. The length ofsuture 332 can slide through the anchoring knot by individually tensioning either the first 334 or thesecond suture tail 336 respectively, with respect to the anchoring knot. -
FIG. 4 c illustrates a sliding embodiment of a wound-ring suture-anchoringdevice 344 providing a sliding connection between suture and a deployed anchoring knot. The wound-ring suture-anchoringdevice 344 comprises asuture ring 346 that can be any type of suture ring described hereinabove. The wound-ring suture-anchoringdevice 344 also comprises a first length ofsuture 348 having afirst suture tail 350 and asecond suture tail 352. The first length ofsuture 348 is wound substantially helically about thesuture ring 346 to configure asuture head 354, with the first 350 and thesecond suture tail 352 extending from thesuture ring 346 substantially adjacent to one another about the circumference of thesuture ring 346. In an alternative embodiment, the first length ofsuture 348 is wound substantially helically about a second length of suture. The second length of suture, with the winding about it, is subsequently joined at aclosure point 356 along its length to form thesuture ring 346. Thesuture head 354 can be collapsed to an anchoring knot by simultaneous tensioning of the first 350 and thesecond suture tail 352 with respect to thesuture head 354. Thus the first 350 and thesecond suture tail 352 comprise collapse tails when tensioned simultaneously. The first length ofsuture 348 can slide through the anchoring knot by individually tensioning either the first 350 or thesecond suture tail 352 respectively, with respect to the anchoring knot. - A sliding embodiment of a crochet-type suture-anchoring
device 362 is illustrated inFIG. 4 d. The crochet-type suture-anchoringdevice 362 comprises a crocheted section ofsuture 364 defining a plurality ofopenings 366 between a firstcrocheted end 368 and a secondcrocheted end 370. The crochetedsection 364 is similar to the crochetedsection 236 described in association withFIG. 3 a. The crochet-type suture-anchoringdevice 362 also comprises a first length ofsuture 372 having afirst suture tail 374 and asecond suture tail 376. - As can be seen in
FIG. 4 d, to configure asuture head 378, the first length ofsuture 372 is woven through one or more of the plurality ofopenings 366 between the firstcrocheted end 368 and the secondcrocheted end 370, and returned to the firstcrocheted end 368 through at least one of the plurality ofopenings 366 near the firstcrocheted end 368. The first 374 and thesecond suture tail 376 extend from the firstcrocheted end 368. In one embodiment, the fraction of the plurality of openings comprises approximately every third opening of the plurality ofopenings 366. In another embodiment, the first length ofsuture 372 is woven through substantially each of the plurality ofopenings 366. In other embodiments, the interval varies along the plurality ofopenings 366 between the firstcrocheted end 368 and the secondcrocheted end 370. In yet another embodiment, the first length ofsuture 372 passes through a single one of the plurality ofopenings 366, the single one of the plurality ofopenings 366 functioning as an eyelet through which the first length ofsuture 372 passes. - A person skilled in the art will appreciate that any number of additional lengths of suture can be independently woven through one or more of the plurality of openings, thereby providing an anchoring device having a plurality of suture legs extending therefrom (a multisuture anchoring device). In various embodiments, two, three or four lengths of suture are each woven through one or more of the plurality of openings, providing anchoring devices respectively comprising four, six, or eight legs of suture extending therefrom. In some surgical situations it can be desirable to increase the number of sutures connected to a deployed anchoring device. In such circumstances, one or more suture needle with attached suture can be passed through a deployed anchoring knot to provide a multisuture anchoring device.
- The
suture head 378 can be collapsed to an anchoring knot by simultaneous tensioning of the first 374 and thesecond suture tail 376 with respect to thesuture head 378. Thus the first 374 and thesecond suture tail 376 comprise collapse tails when tensioned simultaneously with respect to thesuture head 378. The first length ofsuture 372 can slide through the anchoring knot by individually tensioning of either the first 374 or thesecond suture tail 376 respectively, with respect to the anchoring knot. -
FIG. 5 a throughFIG. 5 d illustrate embodiments of suture anchoring devices comprising interpenetrating suture. A suture head according to these embodiments comprises a plurality of longitudinally distributed, substantially transverse penetrations through the material of a first section of suture, and a second section of suture woven through the plurality of penetrations. The plurality of penetrations can comprise any type of penetrations. In one embodiment, the plurality of penetrations is defined using a sharp instrument such as a sewing or suturing needle connected to a suture tail. In another embodiment, the plurality of penetrations comprises a plurality of slits or bores is formed through the suture material to enable weaving of a suture tail therethrough. In yet another embodiment, a plurality of preformed penetrations is provided during fabrication of the section of suture. In still another embodiment, the suture itself comprises a braided material, for example, a braided suture, and the plurality of penetrations pass through the braid at a corresponding plurality of locations. -
FIG. 5 a andFIG. 5 b illustrate interpenetrating sliding embodiments.FIG. 5 a illustrates a firstinterpenetrating sliding embodiment 400 of a suture anchoring device wherein asuture head 402 comprises asuture ring 404 having a plurality ofpenetrations 406 distributed around its circumference. Thesuture ring 404 can be any type of suture ring disclosed herein. Thesuture head 402 further comprises a first length ofsuture 408 woven through the plurality ofpenetrations 406, and terminating in afirst suture tail 410 and asecond suture tail 412, each extending from thesuture head 402 substantially adjacent to one another about the circumference of thesuture ring 404. Thesuture head 402 can be collapsed to an anchoring knot through which the first length ofsuture 408 can slide after the anchoring knot is formed, by simultaneously tensioning the first 410 and thesecond suture tail 412 with respect to thesuture head 402. Thus the first 410 and thesecond suture tail 412 comprise collapse tails when tensioned simultaneously. The first length ofsuture 408 can slide through the anchoring knot by individually tensioning either the first 410 or thesecond suture tail 412 respectively, with respect to the anchoring knot. - In an alternate embodiment, the
suture ring 404 comprises a second length of suture that is open at apoint 418 on the circumference, and the ring shape is maintained by theadjacent penetrations suture 408. In a further alternate embodiment, the second length of suture penetrates the first length of suture, instead of the first length ofsuture 408 penetrating the second length of suture. -
FIG. 5 b illustrates a secondinterpenetrating sliding embodiment 424 of a suture anchoring device wherein asuture head 426 comprises a first length ofsuture 428 having a plurality ofpenetrations 430 along afirst portion 432 of its length, through which asecond portion 434 of the length passes to define a corresponding plurality ofopenings 436. Thesuture head 426 further comprises a second length ofsuture 438 woven through the plurality ofopenings 436, and terminating in afirst suture tail 440 and asecond suture tail 442, each extending from thesuture head 426. Thesuture head 426 can be collapsed to an anchoring knot through which the second length ofsuture 438 can slide, by simultaneously tensioning the first 440 and thesecond suture tail 442 with respect to thesuture head 426. Thus the first 440 and thesecond suture tail 442 comprise collapse tails when tensioned simultaneously. The second length ofsuture 438 can slide through the anchoring knot by individually tensioning either the first 440 or thesecond suture tail 442 respectively, with respect to the anchoring knot. -
FIG. 5 c andFIG. 5 d illustrate interpenetrating suture nonsliding embodiments of suture anchoring devices.FIG. 5 c illustrates a first interpenetratingnonsliding embodiment 448 wherein asuture head 450 having a firsthead end 452 and asecond head end 454 comprises a first length ofsuture 456 having a plurality ofpenetrations 458 along afirst portion 460 of its length between thefirst head end 452 and thesecond head end 454. Asecond portion 462 of the length passes through the plurality ofpenetrations 458 and extends from thefirst head end 452 as asuture tail 464. Thesuture head 450 can be collapsed to an anchoring knot by tensioning thesuture tail 464 with respect to thesuture head 450. In an embodiment, one of thepenetrations 468 of thesecond portion 462 through thefirst portion 454 is reinforced by knotting or by another means to prevent the suture head from unraveling during deployment. The plurality ofpenetrations 458 is seen to define a plurality ofopenings 470 along thesuture head 450 between thefirst head end 454 and thesecond head end 456. -
FIG. 5 d illustrates a second interpenetratingnonsliding embodiment 472. The secondnonsliding embodiment 472 comprises asuture head 474 that resembles thesuture head 450 ofFIG. 5 c, with the addition that in thesecond embodiment 472, thesuture tail 464 is seen to be reversed in direction and additionally woven through one or more of the plurality ofopenings 470, to extend from thesecond head end 454. This additional pass of thesuture tail 464 provides a larger volume of suture material in thesuture head 474 of thesecond embodiment 472, compared with the volume of suture material in thesuture head 450 of thefirst embodiment 448. A larger volume of suture in a suture head provides a correspondingly larger anchoring knot upon deployment in tissue. Thesuture head 474 can be collapsed to an anchoring knot by tensioning thesuture tail 464 with respect to thesuture head 474. - Although sliding and nonsliding embodiments are generally discussed separately hereinabove, various nonsliding embodiments can be converted to sliding embodiments by passing an additional length of suture through an opening in a nonsliding suture head before deployment. For example, with reference to
FIG. 1 , in an embodiment where thesecond suture tail 114 comprises a closed loop of suture, passing a length of suture through the loop before delivering theanchoring device 100 to tissue provides a sliding embodiment of the suture anchoring device, as the passed length of suture will be slidable with respect to the anchoringknot 136. In addition, various sliding embodiments can be converted to nonsliding embodiments, for example, by tying a knot in one or more sliding suture tail. - A person skilled in the art will appreciate that many variations of the suture anchoring devices disclosed herein are within the scope of the present invention, including but not limited to variations in suture material, size, number and combinations of suture lengths used to construct the anchoring device, the number of openings through which suture comprising a collapse tail passes along a suture head, and the number of sliding and nonsliding suture tails extending from a suture head. Further, any number of suture anchoring devices can be coupled together by suture to provide multi-point anchoring systems.
- One application of the suture anchoring devices disclosed herein is the repair of a meniscal tear in a knee.
FIG. 6 a illustrates an embodiment of adual anchoring device 500 according to the present invention that in one embodiment is used for repairing torn meniscal tissue. Thedual anchoring device 500 comprises afirst suture head 502 having a firstdistal end 504 and a firstproximal end 506, and asecond suture head 508 having a seconddistal end 510 and a secondproximal end 512. Thesecond suture head 508 is seen to be positioned proximal to thefirst suture head 502. Thefirst suture head 502 is a sliding suture head that can be any type of sliding suture head disclosed herein, or another sliding suture head. In one embodiment, thefirst suture head 502 is a crochet-type sliding suture head similar to thesuture head 378 described in association withFIG. 4 d. Thefirst suture head 502 comprises twodistal collapse tails proximal end 506 toward thesecond suture head 508. The twodistal collapse tails first suture head 502. Together, the twodistal collapse tails second suture head 508. - The
second suture head 508 is a non-sliding suture head that can comprise any type of nonsliding suture head disclosed herein, or another nonsliding suture head. In one embodiment, thesecond suture head 508 resembles the crochet-typenonsliding suture head 252 described in association withFIG. 2 c, with the addition of an integrated slidingknot 518 extending from the seconddistal end 510. Thesecond suture head 508 also comprises aproximal collapse tail 520 extending proximally from the secondproximal end 512. In one embodiment, thesecond suture head 508, the slidingknot 518, and the twodistal collapse tails knot 518, rather than extending from the seconddistal end 510, is disposed at alocation 521 between seconddistal end 510 and a secondproximal end 512 along thesecond suture head 508. - A partially expanded
view 522 of thedual anchoring device 500 is shown schematically inFIG. 6 b, illustrating the configuration of an embodiment of the slidingknot 518. Afirst one 514 of the twodistal collapse tails knot 518, and to connect to (or be continuous with) thesecond suture head 508 at the seconddistal end 510. The seconddistal collapse tail 516 is seen to pass through the sliding knot to extend proximally from the slidingknot 518, continuous with atensioning tail 524. Thesecond collapse tail 516 is also seen to pass through asuture loop 526 integral with thesecond suture head 508 and extending distally therefrom. - An embodiment of a dual suture
head delivery tool 530 for delivering thedual anchoring device 500 to tissue is schematically illustrated inFIG. 7 a in across-sectional view 532 and inFIG. 7 b in anexternal view 534. The dualhead delivery tool 530 is seen to comprise a cannulateddelivery needle 536 having adistal needle end 538, aproximal needle end 540 and alongitudinal needle cannulation 542 therebetween. Thedelivery needle 536 is proximally coupled to a cannulatedhandle 544 having ahandle wall 546 and a substantiallycylindrical handle cannulation 548, theneedle cannulation 542 being continuous with thehandle cannulation 548. In an embodiment, theneedle 536 is proximally reinforced by a stiffeningmember 550. - A cannulated
piston 552 having adistal piston end 554, aproximal piston end 556 and alongitudinal piston cannulation 557 therebetween, is seen to be disposed slidably within theneedle cannulation 542, and to extend proximally into thehandle cannulation 548. In one embodiment, each of theneedle 536 and thepiston 552 is straight. In another embodiment, theneedle 536 comprises one or more curve between thedistal needle end 538 and theproximal needle end 540, and the piston is flexible enough to be pushed and pulled slidingly through theneedle cannulation 542. In one embodiment, thepiston 552 comprises a flexible tube. In another embodiment, thepiston 552 comprises a flexible, substantially helical coil. - A
piston positioning member 558 is fixedly connected to thepiston 552, and slidably disposed within thehandle cannulation 548. In one embodiment, the positioningmember 558 is an annular member disposed about thepiston 552. In an embodiment, thepiston positioning member 558 substantially irreversibly locks in position longitudinally when maximally advanced distally within thehandle cannulation 548. Any means of locking thepiston positioning member 558 can be used. In one embodiment, thepiston positioning member 558 and thehandle 544 comprise interlocking latchingmembers piston positioning member 558 distally within thehandle 544. - A
control member 564 is connected to thepositioning member 558, for positioning thepiston 552 longitudinally within the dualhead delivery tool 530, from outside the delivery device. For illustrative purposes, the control member is shown rotated ninety degrees about a longitudinal axis of thetool 530 inFIG. 7 a with respect toFIG. 7 b. Thecontrol member 564 extends laterally outward from the positioningmember 558, through a slottedopening 566 in thehandle wall 546. The slottedopening 566 can have any configuration that accommodates the requirements an anchoring device disposed in the delivery device, and corresponding surgical delivery requirements. In one embodiment, as illustrated inFIG. 7 a andFIG. 7 b for delivering thedual anchoring device 500 to tissue, the slottedopening 566 is substantially H-shaped. In an embodiment, the H-shaped opening includes first and secondlongitudinal slots handle wall 546, each of the two slots being adapted by its respective position for delivery of one of the first 502 and thesecond suture head 508 from thedelivery needle 536. In other embodiments, the slotted opening is substantially T-shaped, L-shaped, longitudinally linear, or has another configuration, respective configurations being adapted to accommodate various suture head delivery requirements In another embodiment, the slotted opening comprises means for locking thepiston positioning member 558 distally in thehandle cannulation 548. - The
control member 564 can comprise any means for communicating one or both of longitudinal and circumferential positioning force to thepositioning member 558 and thereby to thepiston 552. In one embodiment, thecontrol member 564 is a shaft fixedly connected to thepositioning member 558 through the slottedopening 566. In another embodiment, thecontrol member 564 includes means to releasable prevent the piston from moving within the dualhead delivery tool 530. In one embodiment, thecontrol member 564 is a thumbscrew that is threaded into thepositioning member 558 through the slottedopening 566, such that rotation of the thumbscrew can be used to selectively lock and unlock the position of the piston within the dualhead delivery tool 530. In another embodiment, thecontrol member 564 is resiliently loaded with respect to thehandle wall 546 to provide a predetermined resistance to movement of thecontrol member 564 along the slottedopening 566. - The
dual anchoring device 500 is seen to be disposed within the dualhead delivery tool 530, substantially within theneedle cannulation 542, distal to the pistondistal end 554. Thesecond collapse tail 520 and thetensioning tail 524 pass proximally from thedual anchoring device 500 through thepiston cannulation 557. Proximal to the pistonproximal end 556, thetensioning tail 524 terminates at atensioning tail end 568 and thesecond collapse tail 520 terminates at a secondcollapse tail end 570. Thesecond collapse tail 520 also comprises a releasable holdingmember 572 disposed proximally to theproximal piston end 556, outside thepiston cannulation 557. The releasable holdingmember 572 prevents thesecond collapse tail 520 from sliding distally through the cannulation of thepiston 552. In one embodiment, the releasable holdingmember 572 is a releasable clamp attached to thesecond collapse tail 520. In another embodiment, the releasable holdingmember 572 is a releasable knot in thesecond collapse tail 520. In a further embodiment, proximally tensioning thesecond collapse tail 520 releases the releasable knot. Upon release of the releasable holdingmember 572, thesecond collapse tail 520 can slide distally through the cannulation of thepiston 552. - The
control member 564 controls the longitudinal position of the distal end of thepiston 552 within thedelivery needle 536, and thereby controls the expulsion of thedual anchoring device 500 from thedelivery needle 536. Depending on the configuration and longitudinal position of the slottedopening 566, thecontrol member 564 can be used to selectively expel only thefirst suture head 502 from thedelivery needle 536 for a predetermined surgical step, and selectively expel thesecond suture head 508 for a later surgical step, thus enabling multipoint anchoring procedures using devices and methods of the present invention. - It can be advantageous, particularly for a delivery device comprising a curved delivery needle, to be able to rotate the handle about a longitudinal axis with respect to the curved needle, to facilitate access to a control member on the handle for a particular procedure, or to accommodate differing preferences between left and right handed surgeons. An embodiment of a curved
needle delivery tool 574 is illustrated inFIG. 8 a. The curvedneedle delivery tool 574 generally resembles the dualhead delivery tool 530 associated withFIG. 7 a andFIG. 7 b, which comprises a straight delivery needle. Thecurved needle embodiment 574 includes a cannulatedcurved delivery needle 576 having adistal delivery end 578 and aproximal end 580 that is rotatably coupled to ahandle 584 about a commonlongitudinal axis 586. Acontrol member 588 is accessible on anoutside surface 590 of thehandle 584. Thecurved delivery needle 576 further comprises one or morecurved portion 592, distal of which thecurved needle 576 deviates from theaxis 586. - In an embodiment, the curved
needle delivery tool 574 comprises a plurality of preferred relative rotational orientations about theaxis 586 between thehandle 584 and thecurved needle 576. In a further embodiment, the plurality of preferred orientations comprises a plurality ofdetents 594 circumferentially distributed about the circumference of one or both of thehandle 590 and thecurved needle 576. In another embodiment, angular markings are provided on one or both of thehandle 584 and thecurved needle 576 to indicate the relative rotational orientation between thecurved needle 576 and thehandle 584.FIG. 8 a illustrates the curvedneedle delivery tool 574 in a firstangular orientation 596 between thehandle 584 and thecurved needle 576.FIG. 8 b illustrates the curvedneedle delivery tool 574 in a secondangular orientation 598 between thehandle 584 and thecurved needle 576. -
FIG. 9 a throughFIG. 9 k schematically illustrate a surgical repair procedure for a torn meniscus in a knee using thedual anchoring device 500 illustrated inFIG. 6 and the dualhead delivery tool 530 illustrated inFIG. 7 . The procedure can be performed arthroscopically or as an open surgical procedure. Before beginning the procedure, the patient is prepared according to known preparatory and surgical techniques including the provision of access to the torn meniscus. The following description of the procedure referencesFIG. 6 andFIG. 7 as well asFIG. 9 a throughFIG. 9 n. Each ofFIG. 9 a throughFIG. 9 n includes an illustration of a surgical step, in some of the figures accompanied by an illustration representing a position of thecontrol member 564 in the substantially H-shaped slottedopening 566 as illustrated inFIG. 7 . -
FIG. 9 a illustrates a first step in which thedelivery needle 536 of the dualhead delivery tool 530 is seen to have been passed through ameniscus 802 that has suffered ameniscal tear 804. Themeniscus 802 is seen to have a firstmeniscal surface 806 which faces toward a femur (not shown) and a secondmeniscal surface 808 which faces laterally or medially away from the femur. It is preferred to minimize the protrusions on thefirst surface 806 facing the femur to minimize irritation etc. of such surface which bears a load from the femur. Thedelivery needle 536 is seen to have penetrated themeniscus 802 at afirst location 810, entering through the firstmeniscal surface 806, and exiting through the secondmeniscal surface 808. Thefirst location 810 is determined by the surgeon performing the procedure, to optimize closure of themeniscal tear 804. In one embodiment, thedelivery needle 536 penetrates through themeniscus 802 across themeniscal tear 804. - The H-shaped slotted
opening 566 is seen to comprise a firstlongitudinal channel 812 and a secondlongitudinal channel 814, each having a respectiveproximal end distal end opening 566 further comprises a bridgingchannel 824 interconnecting the first 812 and thesecond channel 814. Thecontrol member 564 is seen to be positioned at theproximal end 816 of thefirst channel 812. In this position of thecontrol member 564, thedual anchoring device 500 is maximally retracted into thedelivery needle 536. - Now referring to
FIG. 9 b, in a second step, thecontrol member 564 is seen to have been repositioned to thedistal end 820 of thefirst channel 812, thereby expelling thefirst suture head 502 distally from thedelivery needle 536. Thefirst channel 812 does not extend distally far enough to expel thesecond suture head 508 from thedelivery needle 536. Now referring toFIG. 9 c, in a third step, thecontrol member 564 is seen to have been retracted to theproximal end 816 of thefirst channel 812. The refraction of thecontrol member 564 collapses thefirst suture head 502 to afirst anchoring knot 830 as theproximal piston end 556 bears against the releasable holdingmember 572, transmitting tension via theproximal collapse tail 520, thesecond suture head 508, and the twodistal collapse tails first suture head 502. - Now referring to
FIG. 9 d, in a fourth step, thedelivery needle 536 is seen to have been retracted from themeniscus 802, leaving the twodistal collapse tails first anchoring knot 830 and thesecond suture head 508 within thedelivery needle 536. In an embodiment, retracting thedelivery needle 536 positions thefirst anchoring knot 830 proximally against the secondmeniscal surface 808. The control member can move somewhat distally in the firstlongitudinal channel 812 as thedelivery needle 536 is retracted from themeniscus 802. - Now referring to
FIG. 9 e, in a fifth step, thecontrol member 564 is seen to have been moved distally in the firstlongitudinal channel 812 and repositioned into the secondlongitudinal channel 814 via the bridgingchannel 824. Now referring toFIG. 9 f, in a sixth step, thedelivery needle 536 is seen to have been passed through themeniscus 802 at asecond location 838, entering through the firstmeniscal surface 808, and exiting through the secondmeniscal surface 808. Thesecond location 838 is determined by the surgeon to optimize closure of themeniscal tear 804. In one embodiment, thedelivery needle 536 penetrates through themeniscus 802 across themeniscal tear 804. - Now referring to
FIG. 9 g, in a seventh step 840, thecontrol member 564 is seen to have been moved to thedistal end 822 of the secondlongitudinal channel 814, thereby expelling thesecond suture head 508 from thedelivery needle 536 and locking the longitudinal position of thepositioning member 558 and thepiston 552. Now referring toFIG. 9 h, in an eighth step 842, thesecond collapse tail 520 is tensioned 844 proximally to collapse thesecond suture head 508 to asecond anchoring knot 846. In addition, the releasable holdingmember 572 is released in this step. In one embodiment, the releasable holdingmember 572 is a knot in the second collapse tail, and tensioning thesecond collapse tail 520 releases the knot, leaving the secondcollapse tail end 570 free to pass through thepiston cannulation 557. - Now referring to
FIG. 9 i, in a ninth step 848, thedelivery needle 536 is seen to have been retracted from themeniscus 802, leaving thesecond collapse tail 520 and thetensioning tail 524 extending through themeniscus 802 and between thesecond anchoring knot 846 and thedelivery needle 536. Now referring toFIG. 9 j, in a tenth step 850, the dualhead delivery tool 530 is seen to have been removed entirely from the surgical site, leaving thesecond collapse tail 520 and thetensioning tail 524 extending from thesecond anchoring knot 846 and through the firstmeniscal surface 806. Further, proximally tensioning 852 thetensioning tail 524 transmits tension in turn through the slipknot 518 (now part of the second anchoring knot 846) to the seconddistal collapse tail 516, through thefirst anchoring knot 830 and to the firstdistal collapse tail 514, thereby shortening the suture between the first 830 and thesecond anchoring knot 846, to close themeniscal tear 804. Now referring toFIG. 9 k, in an eleventh step 854, thesecond collapse tail 520 and thetensioning tail 524 are seen to have been trimmed to or below the firstmeniscal surface 806, resulting in a repairedmeniscal tear 804. - In an alternate embodiment, one or both of the
tensioning tail 524 and thesecond collapse tail 520 is left untrimmed, and is passed through a closed loop of suture extending distally from an additional suture head, to provide an additional “daisy-chained” suture anchoring point when the additional suture head is delivered to tissue. In one embodiment, the additional suture head is thesuture head 102 ofFIG. 1 , wherein thesecond suture tail 114 comprises the closed loop of suture extending distally from thesecond head end 106. Any number of additional anchoring points can be provided by this daisy-chaining process, as each deployed anchoring knot comprises at least one suture tail that can be passed through a suture loop of yet another suture head, for anchoring to tissue. - One skilled in the art will appreciate that the embodiments illustrated hereinabove of dual suture anchoring devices, associated delivery tools and surgical methods, are readily adapted for single-point, and for other multi-point anchoring embodiments. In one embodiment, a single suture head is disposed in a delivery needle for deployment of a single anchoring knot to tissue. In another embodiment, three suture heads are disposed in a delivery needle, for sequential deployment to tissue as anchoring knots. In yet another embodiment, one or more suture head is disposed in each of two or more delivery needles, with at least one suture bridge interconnecting suture heads disposed in two or more of the delivery needles.
-
FIGS. 9 a to 9 k illustrate atear 804 at least somewhat parallel to thesecond surface 808. However, tears may form in other locations and orientations and the location of anchoringknots tear 804, in which case thefirst anchoring knot 830 could be placed on one side of such tear on thesecond surface 808 the suture being passed through the meniscus to thefirst surface 806 on the same side of the tear and then being passed along thefirst surface 806 across the tear and then back through the meniscus on the other side of the tear to thesecond anchoring knot 846 on the other side of the tear and on thesecond surface 808. Preferably all knots and other significant protrusions on the suture are kept on thesecond surface 808 and not on thefirst surface 806 facing the femur or other surfaces under load such as one which face towards the tibia (not shown). - An embodiment of a single suture
head delivery tool 860 that can be used for anchoring suture to tissue at a single location, or for daisy-chaining suture anchoring devices according to the present invention, is schematically illustrated inFIG. 10 a in across-sectional view 862 and inFIG. 10 b in an external view 864. The singlehead delivery tool 860 resembles the dualhead delivery tool 530 disclosed hereinabove. - The single
head delivery tool 860 is seen to comprise a cannulateddelivery needle 866 having adistal needle end 868, aproximal needle end 870 and alongitudinal needle cannulation 872 therebetween. Thedelivery needle 866 is proximally coupled to a cannulatedhandle 874 having ahandle wall 876 and a substantiallycylindrical handle cannulation 878, theneedle cannulation 872 being continuous with thehandle cannulation 878. In an embodiment, theneedle 866 is proximally reinforced by a stiffeningmember 880. - A cannulated
piston 882 having adistal piston end 884, aproximal piston end 886 and alongitudinal piston cannulation 888 therebetween is seen to be disposed slidably within theneedle cannulation 872, and to extend proximally into thehandle cannulation 878. Theneedle 866 can be straight or curved as disclosed hereinabove for the dualhead delivery tool 530. Apiston positioning member 890 is fixedly connected to thepiston 882, and slidably disposed within thehandle cannulation 878. In one embodiment, thepiston positioning member 890 is an annular member disposed about thepiston 882. In an embodiment, thepiston positioning member 890 substantially irreversibly locks in position longitudinally when maximally advanced distally within thehandle cannulation 878, as disclosed hereinabove for the dualhead delivery tool 530. - A
control member 892 is connected to thepositioning member 890, for positioning thepiston 882 longitudinally within thedelivery tool 860, from outside thedelivery tool 860. Thecontrol member 892 can be of the same construction as thecontrol member 564 disclosed hereinabove, or of another construction. Thecontrol member 892 extends laterally outward from the positioningmember 890, through a slottedopening 894 in thehandle wall 876. The slottedopening 894 comprises alongitudinal channel 896 through the handle wall. Thelongitudinal channel 896 is seen to have adistal channel end 898 and aproximal channel end 900. In one embodiment, as illustrated inFIG. 10 , the slottedopening 894 also comprises atransverse channel 902 intersecting thelongitudinal channel 896 at an intermediate location between theproximal channel end 898 and thedistal channel end 900, providing a “T” shaped opening. - A single head
suture anchoring device 904 is seen to be disposed within the singlehead delivery tool 860, substantially within theneedle cannulation 872 and distal to thedistal piston end 884. The singlehead anchoring device 904 comprises asuture head 906 and at least onecollapse tail 908 extending proximally from thesuture head 906 through thepiston cannulation 888. The singlehead anchoring device 904 can comprise a nonsliding or a sliding suture head. In one daisy-chaining embodiment, thesuture head 904 is a nonsliding suture head that also comprises adistal suture loop 910 disposed at the distal end of thesuture head 906, and a releasable holdingmember 912 disposed proximally to theproximal piston end 886, the releasable holdingmember 912 can be any type of releasable holding member disclosed hereinabove in association with the dualhead delivery tool 530. - The releasable holding
member 912 prevents thecollapse tail 908 from sliding distally through thepiston cannulation 888. Further, with the releasable holdingmember 912 in place, proximally retracting thepiston 882 also retracts thesuture anchoring device 904, along with thesuture loop 910, into theneedle cannulation 872 without collapsing thesuture head 906 to an anchoring knot. Upon release of the releasable holding member, thecollapse tail 908 can slide distally through thepiston cannulation 888. -
FIG. 11 a throughFIG. 11 i schematically illustrate an embodiment of surgical steps for a daisy-chaining procedure using the singlehead delivery tool 860 and the daisy-chaining embodiment of the single-headsuture anchoring device 904. The daisy-chaining procedure can be performed as part of an arthroscopic procedure or an open surgical procedure wherein a suture tail anchored to tissue is provided by earlier surgical steps. The following description of the procedure referencesFIG. 10 as well asFIG. 11 a throughFIG. 11 i. Each ofFIG. 11 a throughFIG. 11 i includes an illustration of a surgical step, in some of the figures accompanied by an illustration representing a position of thecontrol member 892 in the substantially T-shaped slottedopening 894 as illustrated inFIG. 10 . -
FIG. 11 a illustrates a first step in the daisy-chaining procedure. An anchoredsuture tail 922 is seen to have been anchored at afirst location 924 totissue 926 having afirst surface 928 and asecond surface 930. In one embodiment, the anchoredsuture tail 922 is anchored to thetissue 926 by afirst anchoring knot 932 according to the present invention. In another embodiment, the anchoredsuture tail 922 is anchored to thetissue 926 by another type of suture anchoring device. The anchoredsuture tail 922 is seen to have been passed through thesuture loop 910 of the singlehead anchoring device 904 disposed in the singlehead delivery tool 860. Thecontrol member 892 is seen to be disposed in thetransverse channel 902 of the slottedopening 894. - Now referring to
FIG. 11 b, in a second step, thecontrol member 892 is seen to have been moved from thetransverse channel 902 to thelongitudinal channel 896 and to theproximal channel end 900, retracting the single-headsuture anchoring device 904, including thedistal suture loop 910, into the distal end of theneedle cannulation 872. This retraction step provides retention of the anchoredsuture tail 922 to the singlehead delivery tool 860. Now referring toFIG. 11 c, in a third step, theneedle 866 of the singlehead delivery tool 860, along with the retained, anchoredsuture tail 922, is seen to have been passed distally through thetissue 926 at asecond location 938. The anchoredsuture tail 922 is seen to bridge the span of thetissue 926 between the first 924 and thesecond location 938, to pass distally through thetissue 926 alongside theneedle 866, through the distal suture loop 910 (inside the needle cannulation 872) and return proximally through thetissue 926 to extend proximally as atensioning tail 940. - Now referring to
FIG. 11 d, in a fourth step, thecontrol member 892 is seen to have been moved along thelongitudinal channel 896 to thedistal channel end 898, thereby expelling thesuture head 906 distally from thedelivery needle 866. Now referring toFIG. 11 e, in a fifth step, thecollapse tail 908 is seen to have been tensioned 946 proximally, thereby collapsing thesuture head 906 to asecond anchoring knot 948. In addition, the releasable holdingmember 912 is released in this step. Now referring toFIG. 11 f, in a sixth step, thedelivery needle 866 is seen to have been retracted from thetissue 926, leaving thecollapse tail 908 extending from thesecond anchoring knot 948 and through thepiston cannulation 888. The anchoredsuture tail 922 is seen to bridge the span of thetissue 926 between the first 932 and thesecond anchor knot 948, passing through thetissue 926 at the first 924 and thesecond location 938. Further, thetensioning tail 940 extends proximally through thetissue 926 from thesecond anchoring knot 948. - Now referring to
FIG. 11 g, in a seventh step, the singlehead delivery tool 860 is seen to have been removed entirely from the surgical site, leaving thecollapse tail 908 and thetensioning tail 940 extending proximally from thesecond anchoring knot 948 and through thetissue 926. Proximally tensioning thetensioning tail 940 transmits tension through the distal suture loop 910 (now part of the second anchoring knot 948) to the anchoredsuture tail 922, thereby shortening the suture between the first 932 and thesecond anchoring knot 948. In an embodiment, thetissue 926 comprises a tear between the first 924 and thesecond location 938, and tensioning 954 thetensioning tail 940 applies a closing force to the tear. - Now referring to
FIG. 11 h, in an eighth step, aknot 958 is seen to have been tied between the tensioningtail 940 and thecollapse tail 908 to prevent loosening of the tension applied to thetensioning tail 940 in theseventh step 952. Theknot 958 can be positioned adjacent thesecond anchoring knot 948 using a knot pusher or another known surgical technique. Finally, referring toFIG. 11 i, in a ninth step, thecollapse tail 908 and thetensioning tail 940 are seen to have been trimmed to or below thefirst tissue surface 928. In an alternate embodiment, one or both of thetensioning tail 940 and thecollapse tail 908 is left untrimmed, and is passed through a closed loop of suture extending distally from an additional suture head, to provide a starting point for additional daisy-chaining to other suture anchoring locations. -
FIG. 12 a throughFIG. 12 e schematically illustrate an embodiment of an alternative delivery system and method for anchoring suture to tissue according to the present invention. The alternative delivery system is particularly useful for surgical procedures wherein delivery of a suture head to relatively hard tissue such as cortical bone is required, and for procedures wherein full distal extension of the suture head from a delivery needle is acceptable before collapsing the suture head to an anchoring knot. - Referring to
FIG. 12 a, in a first step, asuture anchoring device 963 is seen to be disposed in a cannulateddelivery needle 964 having alongitudinal needle cannulation 966. A longitudinally slidable, cannulatedpiston 968 having alongitudinal piston cannulation 970 is seen to be positioned within theneedle cannulation 966. In an embodiment, thesuture anchoring device 963 is a sliding type device comprising asuture head 972 having adistal head end 974, aproximal head end 976 and two collapsetails proximal head end 976. Thecollapse tails piston 968, and an interior surface of thedelivery needle 964. Apusher rod 982 having adistal fork 984 is seen to be disposed through thepiston cannulation 970 and distally through or alongside thesuture head 972, to engage a portion ofsuture 986 from which thesuture head 972 is configured, in proximity to thedistal head end 974. Thedelivery needle 964 is seen to be positioned in the entrance of ananchoring hole 988 prepared intissue 990. In the embodiment illustrated inFIG. 12 a throughFIG. 12 e, thetissue 990 is bone, the anchoringhole 988 penetrating through acortical layer 992 and intocancellous bone 994. Theanchoring hole 988 can be prepared using any surgical drilling or other bone-penetrating method. - Now referring to
FIG. 12 b, in a second step, thepusher rod 982 is seen to have been used to push thesuture head 972 distally from theneedle 964 into theanchoring hole 988, with thepiston 968 following the distal motion of thesuture head 972. In an embodiment, thepiston 968 is used in concert with thepusher rod 982 to push thesuture head 972 from theneedle 964. Now referring toFIG. 12 c, in a third step, thepusher rod 982 is seen to have been removed, leaving thesuture head 972 positioned against the distal end of thepiston 968. Now referring toFIG. 12 d, in a fourth step, thesuture head 972 is seen to have been collapsed to ananchoring knot 1002 by proximally tensioning the twocollapse tails FIG. 12 e, in a fifth step, theneedle 964 andpiston 968 therein are seen to have been removed proximally from the anchoringhole 988, leaving the twocollapse tails tissue 994 and available for further use in a surgical procedure. - In particularly hard tissue, such as hard cancellous bone behind overlying cortical bone, tensioning of one or more collapse tail may be insufficient to fully expand a suture head against the walls of a receiving hole in the hard tissue to fully form an anchoring knot. In surgical situations where this may be the case, the diameter of the hole in the cancellous bone is preferably expanded without enlarging the entrance through the cortical bone, before a delivery needle is inserted to deliver the anchoring device.
FIG. 13 illustrates a modifiedanchoring hole 1010 inbone 1012 wherein acancellous portion 1014 of theanchoring hole 1010 is seen to have been dilated relative to acortical portion 1016 of theanchoring hole 1010, to accommodate deployment of ananchoring knot 1018. Dilating thecancellous portion 1014 of theanchoring hole 1010 can be accomplished by any means, including but not limited to a curved cutting tool that can be inserted through thecortical portion 1016 of theanchoring hole 1010, a tool that can be inserted into a drilled hole and deployed radially outward from an axis of insertion, a drill bit having a radially deployable cutting member near a distal end, and ultrasonic or other powered cutting tools. -
FIG. 14 a throughFIG. 14 d schematically illustrate an alternative embodiment of a suture anchoring device according to the present invention, and its delivery to tissue, wherein a cannulated delivery needle is not required to deliver a suture head to tissue. Referring toFIG. 14 a, asuture anchoring device 1020 is seen to comprise anonsliding suture head 1022 that can comprise any type of nonsliding suture head disclosed herein. Thesuture head 1022 is seen to have afirst head end 1024 and asecond end 1026. Extending from thefirst end 1024 is acollapse tail 1028, and extending from thesecond end 1026 is adelivery suture tail 1030 terminated with a tissue-penetratingtool 1032 that in various embodiments is a suturing needle or a surgical guidewire. Thedelivery tail 1030 is not configured as a collapse tail, so tensioning thedelivery tail 1030 with respect to thesuture head 1022 does not collapse thesuture head 1022 to an anchoring knot. - In an embodiment, the
suture anchoring device 1020 is used in a surgical procedure performed from inside 1034 a patient's body, such as an arthroscopic procedure, to anchor suture to a firstinternal body tissue 1036 underlying theskin 1038 of the patient. In an embodiment, the firstinternal tissue 1036 also underlies a secondinternal body tissue 1040 beneath theskin 1038. In one embodiment, the firstinternal tissue 1036 is a meniscus of a knee, and the secondinternal tissue 1040 is a joint capsule of the knee. - Now referring to
FIG. 14 b, illustrating a first surgical step, the tissue-penetratingtool 1032 is seen to have been passed from inside 1034 the patient through thefirst body tissue 1036, thesecond body tissue 1040 and theskin 1038. In addition, thesuture head 1022 has been pulled through thefirst body tissue 1036, disposing thesuture head 1022 between thefirst body tissue 1036 and theskin 1038. Referring now toFIG. 14 c, in a deployment step, thecollapse tail 1028 and thedelivery tail 1030 are seen to have both been tensioned with respect to thesuture head 1022, to collapse thesuture head 1022 to ananchoring knot 1050. Finally, now referring toFIG. 14 d, in a finishing step, the anchoring knot is seen to have been anchored against the first body tissue by tensioning thecollapse tail 1028, and thedelivery tail 1030 is seen to have been trimmed, leaving no suture protruding above theskin 1038. Thedelivery tail 1030, anchored by theanchoring knot 1050, is then available for further use in the surgical procedure, for connection to another tissue or implantable device (not illustrated inFIG. 14 a-FIG. 14 d). - In addition to providing anchoring of suture directly to tissue, the suture anchoring devices of the present invention disclosed hereinabove can be used to anchor suture to an intermediate implant that itself can be fixed to tissue. The intermediate implant can be any of a variety of implant types including but not limited to a suture anchor, a cannulated screw or rivet, and another implanted object such as a bone plate. Fixation of the intermediate implant to tissue can be by any known means including but not limited to interference, toggling, screw threads, expandable or extendable members, adhesives and cements.
FIG. 15 a throughFIG. 15 d illustrate in cross-section, an embodiment of a suture anchoring system and associated method incorporating a suture head that can be any type of suture head disclosed hereinabove, and an intermediate implant for fixation to tissue. - First referring to
FIG. 15 a, a tissue-anchoringbody 1060 is seen to be provided for fixation in ahole 1062 intissue 1064 that in one embodiment is bone having acortical layer 1066 and acancellous layer 1068. The tissue-anchoringbody 1060 is seen to have aproximal end 1070, adistal end 1072 and acannulation 1074 extending therebetween. In an embodiment, thecannulation 1074 has a substantially fixed cross-sectional dimension (diameter, if the cannulation has a circular cross section) along its length. The tissue-anchoringbody 1060 is seen to further include one or moreexternal fixation member 1076 for fixing the tissue-anchoringbody 1060 in thehole 1062. Any known method can be used for preparing thehole 1062 in thetissue 1064 and for fixing theanchoring body 1060 therein. - In the present embodiment, the one or
more fixation member 1076 comprises external screw threads on theanchoring body 1060, for engagement with an inner wall of thehole 1062. Theanchoring body 1060 also includes a tool-engagingfeature 1078 for releasable connection of acomplementary insertion tool 1080 to theanchoring body 1060, for rotationally threading theanchoring body 1060 into thehole 1062. The tool-engagingfeature 1078 can comprise a noncircular internal cross-section of thecannulation 1074 along at least a portion of its length between theproximal end 1070 and thedistal end 1072. The noncircular cross section can be any type of cross section effective for rotational engagement, such as a hexagonal internal cross-section for receiving theinsertion tool 1080, or other configurations including but not limited to square, star-shaped and other screwdriver-type fittings and the like. In another embodiment, theanchoring body 1060 comprises a self-drilling screw that can be fixed into thetissue 1064 without provision of a pre-drilled hole.FIG. 15 b illustrates the tissue-anchoringbody 1060 fixed to thetissue 1064. - Now referring to
FIG. 15 c, adelivery tool 1082 for delivering asuture head 1084 comprising one or more proximally extendingsuture tail 1086, is seen to have been disposed at least partially through thecannulation 1074 from theproximal end 1070 toward thedistal end 1072 of theanchoring body 1060. Thedelivery tool 1082 preferably includes astop element 1088 that determines a maximum insertion depth of thedelivery tool 1082 into thecannulation 1074. With thedelivery tool 1082 thus disposed in thecannulation 1074, thesuture head 1084 is delivered distally from thedelivery tool 1082 using methods and apparatus disclosed hereinabove. Now referring toFIG. 15 d, thesuture head 1084 is seen to have been delivered distally beyond thedistal end 1072 of thecannulation 1074, and collapsed to ananchoring knot 1090 that has a larger cross sectional dimension than that of thecannulation 1074, to resist pullout of theanchoring knot 1090 proximally through thecannulation 1074 when the one ormore suture tail 1086 is tensioned. Thedelivery tool 1082 is also seen inFIG. 15 d to have been removed from thecannulation 1074. - In various embodiments, the
insertion tool 1080 is removed from theanchoring body 1060 following fixation of theanchoring body 1060 to thetissue 1064, as illustrated inFIG. 15 b, or left connected to theanchoring body 1060 following fixation. In an embodiment wherein theinsertion tool 1080 is left connected to theanchoring body 1060 following fixation of theanchoring body 1060 to thetissue 1064, theinsertion tool 1080 is cannulated for receiving thedelivery tool 1082 therethrough and to thecannulation 1074. In this embodiment, theinsertion tool 1080 also functions as a guide for assisting a surgeon in locating thecannulation 1074 for deploying thesuture head 1084. - Another embodiment of a suture anchoring system and associated method incorporating a suture head and an intermediate implant for fixation to tissue is illustrated in
FIG. 16 a throughFIG. 16 d. The embodiment ofFIG. 16 a throughFIG. 16 d resembles the embodiment ofFIG. 15 a throughFIG. 15 d, except that, in the embodiment ofFIG. 16 a throughFIG. 16 d, an anchoring knot is contained substantially within an intermediate implant after deployment, rather than distal to the intermediate implant. - Referring first to
FIG. 16 a, a knot-holdinganchoring body 1094 for fixation in thehole 1062 in thetissue 1064 is provided. The knot-holdinganchoring body 1094 is seen to have aproximal end 1096, adistal end 1098 and avariable cross-section cannulation 1100 extending therebetween. The knot-holdinganchoring body 1094 is seen to resemble thetissue anchoring body 1060 ofFIG. 15 a throughFIG. 15 d, except that thevariable cross-section cannulation 1100 is seen to include anenlarged diameter portion 1102 distally spaced from theproximal end 1096. In an embodiment, the variable cross-section cannulation is stepped 1104 in cross-section along its length, having a greater cross-section at thedistal end 1098 than at aproximal end 1096. In another embodiment, thevariable cross-section cannulation 1094 is substantially closed at thedistal end 1098 of the knot-holdinganchoring body 1094.FIG. 16 b illustrates the knot-holdinganchoring body 1094 fixed to thetissue 1064. - Now referring to
FIG. 16 c, thesuture head 1084 is seen to be disposed in thedelivery tool 1084 as described in association withFIG. 15 c, but, as illustrated inFIG. 16 d, delivered into theenlarged portion 1102 of thevariable cannulation 1100 for collapse to ananchoring knot 1106 disposed substantially within the variable cannulation. In an embodiment, theanchoring knot 1106 conforms to an internal cross section of theenlarged portion 1102 of thevariable cannulation 1100. Hybrid embodiments such as those ofFIG. 15 a throughFIG. 16 d, comprising both a suture head and an intermediate implant, are useful, for example, in surgical procedures where a hole or a slot in the intermediate implant is or can be provided for anchoring suture in one or more location on the implant. - Following deployment through a preformed hole or cannulation of a first anchoring device according to the present invention, one or more suture leg extends from a first anchoring knot and proximally through the hole or cannulation. In a multi-anchor embodiment, a cross-sectional dimension of the preformed hole or cannulation is sized to permit passage of a delivery tool for a second anchoring device through the hole or cannulation, alongside the one or more suture leg. Thus sizing the hole or cannulation enables the deployment of two or more anchoring devices through the hole or cannulation, as determined by the surgeon according to the requirements of a surgical procedure.
- Suture anchoring devices according to the present invention have many advantages, including but not limited to advantages associated with their structure and materials of construction, versatility of application and delivery, reduced surgical trauma, fixation strength, and failure mode. With regard to materials of construction, suture-anchoring devices according to the present invention advantageously made substantially from suture present no materials compatibility issues between the materials used for an anchor body and suture connected thereto. Further, the present invention can provide suture anchoring devices and associated sutures constructed from a single continuous length of suture, advantageously eliminating all interfaces among anchor components.
- In addition, suture-anchoring devices made substantially from suture have no sharp edges or corners that can damage the tissue in which they are implanted. Further, the materials of construction can be selected from among a broad variety of available suture materials, including materials that can provide one or more of great mechanical strength, excellent tissue compatibility, controlled bioabsorbability and tissue ingrowth, and other desirable properties suitable for a surgical repair procedure. Still further, mechanical and chemical treatment of sutures for controlling lubricity, knotting, or chemical elution, is well known in this art and readily applied to entire suture-anchoring devices of the present invention, or to sections thereof by treating only a portion of the suture used to construct a suture anchoring device. Yet further, knotted anchoring configurations themselves provided by the present invention are relatively open structures that can encourage tissue ingrowth for enhanced healing.
- Suture anchoring devices according to the present invention are advantageously delivered to tissue via a cannulated delivery needle having a diameter only a few times the diameter of the suture from which the anchoring device is constructed, thereby minimizing surgical trauma associated with the delivery method. Delivery can be to a space behind a tissue wall, or into bulk tissue, for example, into cartilage or into cancellous bone behind a small-diameter penetration through overlying cortical bone. In addition, the cross-sectional size of a deployed anchoring knot in tissue is determined primarily by the length of a suture head disposed in the delivery needle, so a wide range of anchor knot sizes, and therefore deployed retention strengths, can be delivered using a given delivery needle diameter. This feature enables the fixation strength of a repair to be tailored for a specific surgical procedure, up to the failure strength of the suture material, and without such issues as cheese-wiring of anchor materials, or breakage of suture at sharp corners of an anchor body. Also advantageously, if a repair performed using anchoring devices according to the present invention does fail, no potentially injurious sharp-edged or pointed fragments from a failed anchor body are produced.
- Suture anchoring devices according to the present invention are particularly advantageous for performing minimally invasive repairs of damaged tissue, such as repairs of soft tissue tears or separations from underlying bone. As one nonlimiting example, a minimally invasive repair of a partial thickness a rotator cuff tear could be performed by passing a small diameter delivery needle containing one or more suture head through tissue of the damaged rotator cuff and into underlying bone of the humerus, for anchoring suture in the bone, for reapproximating the rotator cuff tissue to the bone with minimum surgical trauma.
- Because the suture head is flexible, the delivery needle can be shaped to include one or more bend or a curve along its length, for optimizing access to a surgical site and further minimizing surgical trauma. Exemplary shapes of the delivery needle can include a substantially 180 degree U-turn along the needle, as well as any other angle turn, and a helical (corkscrew-shaped) delivery needle. Further, the suture head can be collapsed to an anchoring knot as it is being expelled from the needle, thereby minimizing the penetration depth into or through tissue required for deployment. This feature is particularly advantageous, for example, where anchoring of suture is required to a small bone, or within a shallow space behind a tissue wall. For instance,
FIG. 1 b shows thesuture head 102 protruding in full length beyond theneedle 116. However, by simultaneously tensioning thesuture tail 112 while forcing thesuture head 102 out with thepiston 128 rather than thesuture head 102 protruding in full length, it just expands into the anchoringknot 136 at the needledistal end 120. - Great breadth of applicability is provided by the present invention, as various embodiments of the suture anchoring devices disclosed herein include either or both of fixed and slidable coupling between an anchoring knot and suture. In addition, a plurality of suture-coupled anchoring devices can be delivered from a single delivery needle. Further, the plurality of anchoring devices in a single delivery needle can include more than one type of anchoring device. Yet further, an adhesive or cement can be injected with the anchoring device, to additionally stabilize a repair.
- One skilled in the art will appreciate further features and advantages of the invention based on the above-described embodiments, and that the invention is applicable to open, minimally invasive and robotically-assisted surgery. Further, surgical steps recited herein can be varied in their details, order of execution, and necessity of inclusion in a procedure, without deviating from the intent and scope of the present invention. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.
Claims (26)
Priority Applications (9)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/509,112 US8828053B2 (en) | 2009-07-24 | 2009-07-24 | Methods and devices for repairing and anchoring damaged tissue |
AU2010202936A AU2010202936B2 (en) | 2009-07-24 | 2010-07-12 | Methods and devices for repairing and anchoring damaged tissue |
CA2710885A CA2710885A1 (en) | 2009-07-24 | 2010-07-22 | Methods and devices for repairing and anchoring damaged tissue |
JP2010165574A JP5661361B2 (en) | 2009-07-24 | 2010-07-23 | Method and device for repairing and fixing damaged tissue |
CN201010236588.2A CN101961257B (en) | 2009-07-24 | 2010-07-23 | For repairing the method and apparatus with grappling damaged tissues |
EP10251328.0A EP2277457B1 (en) | 2009-07-24 | 2010-07-26 | Devices for repairing and anchoring damaged tissue |
US14/455,331 US10004495B2 (en) | 2009-07-24 | 2014-08-08 | Methods and devices for repairing and anchoring damaged tissue |
US15/991,189 US11141149B2 (en) | 2009-07-24 | 2018-05-29 | Methods and devices for repairing and anchoring damaged tissue |
US17/471,283 US20210401432A1 (en) | 2009-07-24 | 2021-09-10 | Methods and devices for repairing and anchoring damaged tissue |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/509,112 US8828053B2 (en) | 2009-07-24 | 2009-07-24 | Methods and devices for repairing and anchoring damaged tissue |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US14/455,331 Continuation US10004495B2 (en) | 2009-07-24 | 2014-08-08 | Methods and devices for repairing and anchoring damaged tissue |
Publications (2)
Publication Number | Publication Date |
---|---|
US20110022083A1 true US20110022083A1 (en) | 2011-01-27 |
US8828053B2 US8828053B2 (en) | 2014-09-09 |
Family
ID=42827328
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/509,112 Active 2031-05-29 US8828053B2 (en) | 2009-07-24 | 2009-07-24 | Methods and devices for repairing and anchoring damaged tissue |
US14/455,331 Active 2031-02-18 US10004495B2 (en) | 2009-07-24 | 2014-08-08 | Methods and devices for repairing and anchoring damaged tissue |
US15/991,189 Active 2029-11-21 US11141149B2 (en) | 2009-07-24 | 2018-05-29 | Methods and devices for repairing and anchoring damaged tissue |
US17/471,283 Pending US20210401432A1 (en) | 2009-07-24 | 2021-09-10 | Methods and devices for repairing and anchoring damaged tissue |
Family Applications After (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US14/455,331 Active 2031-02-18 US10004495B2 (en) | 2009-07-24 | 2014-08-08 | Methods and devices for repairing and anchoring damaged tissue |
US15/991,189 Active 2029-11-21 US11141149B2 (en) | 2009-07-24 | 2018-05-29 | Methods and devices for repairing and anchoring damaged tissue |
US17/471,283 Pending US20210401432A1 (en) | 2009-07-24 | 2021-09-10 | Methods and devices for repairing and anchoring damaged tissue |
Country Status (6)
Country | Link |
---|---|
US (4) | US8828053B2 (en) |
EP (1) | EP2277457B1 (en) |
JP (1) | JP5661361B2 (en) |
CN (1) | CN101961257B (en) |
AU (1) | AU2010202936B2 (en) |
CA (1) | CA2710885A1 (en) |
Cited By (138)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20060282085A1 (en) * | 2004-11-09 | 2006-12-14 | Arthrotek, Inc. | Soft tissue conduit device |
US20080255613A1 (en) * | 2007-04-10 | 2008-10-16 | Biomet Sports Medicine, Inc. | Adjustable knotless loops |
US20100211075A1 (en) * | 2006-09-29 | 2010-08-19 | Biomet Sports Medicine, Llc | Fracture Fixation Device |
US20110022084A1 (en) * | 2009-07-24 | 2011-01-27 | Mehmet Ziya Sengun | Methods and devices for repairing and anchoring damaged tissue |
US20110218625A1 (en) * | 2006-02-03 | 2011-09-08 | Biomet Sports Medicine, Llc | Method and Apparatus for Fixation of an ACL Graft |
US20110270278A1 (en) * | 2010-04-27 | 2011-11-03 | Tom Overes | Anchor assembly including expandable anchor |
US20120004669A1 (en) * | 2010-04-27 | 2012-01-05 | Tom Overes | Insertion instrument for anchor assembly |
WO2012061586A1 (en) * | 2010-11-04 | 2012-05-10 | Looploc, Inc. | Method and apparatus for securing an object to bone using a suture assembly |
US20120197271A1 (en) * | 2011-01-28 | 2012-08-02 | Smith & Nephew, Inc. | Tissue repair |
WO2012125617A1 (en) * | 2011-03-14 | 2012-09-20 | Reznik Alan M | Nonlinear self seating suture anchor for confined spaces |
WO2013016552A1 (en) * | 2011-07-26 | 2013-01-31 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US8435264B2 (en) | 2010-08-30 | 2013-05-07 | Depuy Mitek, Llc | Knotless suture anchor and driver |
US8460340B2 (en) | 2010-08-30 | 2013-06-11 | Depuy Mitek, Llc | Knotless suture anchor |
US8469998B2 (en) | 2010-08-30 | 2013-06-25 | Depuy Mitek, Llc | Knotless suture anchor |
EP2662030A1 (en) | 2012-05-07 | 2013-11-13 | DePuy Mitek, LLC | Systems, devices, and methods for securing tissue using snare assemblies and soft anchors |
US20140039552A1 (en) * | 2012-08-03 | 2014-02-06 | Howmedica Osteonics Corp. | Soft tissue fixation devices and methods |
US20140114404A1 (en) * | 2011-06-27 | 2014-04-24 | University Of Maryland, Baltimore | Transapical mitral valve repair device |
US20140155930A1 (en) * | 2012-12-04 | 2014-06-05 | Cook Medical Technologies Llc | Inferior filter retrieval device |
US20140188163A1 (en) * | 2012-12-27 | 2014-07-03 | Depuy Mitek, Llc | Surgical constructs and methods for securing tissue |
US8771316B2 (en) | 2006-02-03 | 2014-07-08 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US8790370B2 (en) | 2012-03-30 | 2014-07-29 | Depuy Mitek, Llc | Surgical filament assemblies |
US8814905B2 (en) | 2010-11-23 | 2014-08-26 | Depuy Mitek, Llc | Surgical filament snare assemblies |
US8821543B2 (en) | 2010-12-23 | 2014-09-02 | Depuy Mitek, Llc | Adjustable anchor systems and methods |
US8821545B2 (en) | 2010-11-23 | 2014-09-02 | Depuy Mitek, Llc | Surgical filament snare assemblies |
US8828053B2 (en) | 2009-07-24 | 2014-09-09 | Depuy Mitek, Llc | Methods and devices for repairing and anchoring damaged tissue |
US8840645B2 (en) | 2004-11-05 | 2014-09-23 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8894684B2 (en) | 2012-05-07 | 2014-11-25 | Medos International Sàrl | Systems, devices, and methods for securing tissue using a suture having one or more protrusions |
US8900314B2 (en) | 2009-05-28 | 2014-12-02 | Biomet Manufacturing, Llc | Method of implanting a prosthetic knee joint assembly |
US8911474B2 (en) | 2009-07-16 | 2014-12-16 | Howmedica Osteonics Corp. | Suture anchor implantation instrumentation system |
US8926662B2 (en) | 2012-02-01 | 2015-01-06 | Smith & Nephew, Inc. | Tissue graft anchoring |
US8936621B2 (en) | 2006-02-03 | 2015-01-20 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US8986327B2 (en) | 2012-10-18 | 2015-03-24 | Smith & Nephew, Inc. | Flexible anchor delivery system |
US9005287B2 (en) | 2006-02-03 | 2015-04-14 | Biomet Sports Medicine, Llc | Method for bone reattachment |
US9060764B2 (en) | 2012-05-07 | 2015-06-23 | Medos International Sàrl | Systems, devices, and methods for securing tissue |
US9060763B2 (en) | 2012-05-07 | 2015-06-23 | Medos International Sàrl | Systems, devices, and methods for securing tissue |
US9084597B2 (en) | 2012-03-09 | 2015-07-21 | Smith & Nephew, Inc. | Suture-based knotless repair |
US9095331B2 (en) | 2010-12-23 | 2015-08-04 | Medos International Sàrl | Adjustable anchor systems and methods |
US9119893B2 (en) | 2010-11-04 | 2015-09-01 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US9149267B2 (en) | 2006-02-03 | 2015-10-06 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9173651B2 (en) | 2006-02-03 | 2015-11-03 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US20150335325A1 (en) * | 2013-01-04 | 2015-11-26 | Anchor Orthopedics Xt Inc. | Devices And Methods for Advancing Knots |
US9216078B2 (en) | 2011-05-17 | 2015-12-22 | Biomet Sports Medicine, Llc | Method and apparatus for tibial fixation of an ACL graft |
US20160000427A1 (en) * | 2014-07-04 | 2016-01-07 | Fung-Chao Tu | Suturing and knotting integrated device for laparaoscopic surgery and associated knotting assembly |
US9271713B2 (en) | 2006-02-03 | 2016-03-01 | Biomet Sports Medicine, Llc | Method and apparatus for tensioning a suture |
US9307978B2 (en) | 2010-11-04 | 2016-04-12 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US9314241B2 (en) | 2011-11-10 | 2016-04-19 | Biomet Sports Medicine, Llc | Apparatus for coupling soft tissue to a bone |
US9357991B2 (en) | 2011-11-03 | 2016-06-07 | Biomet Sports Medicine, Llc | Method and apparatus for stitching tendons |
US9370350B2 (en) | 2011-11-10 | 2016-06-21 | Biomet Sports Medicine, Llc | Apparatus for coupling soft tissue to a bone |
US9381013B2 (en) | 2011-11-10 | 2016-07-05 | Biomet Sports Medicine, Llc | Method for coupling soft tissue to a bone |
US9402620B2 (en) | 2013-03-04 | 2016-08-02 | Howmedica Osteonics Corp. | Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use |
US9402621B2 (en) | 2006-02-03 | 2016-08-02 | Biomet Sports Medicine, LLC. | Method for tissue fixation |
US9414925B2 (en) | 2006-09-29 | 2016-08-16 | Biomet Manufacturing, Llc | Method of implanting a knee prosthesis assembly with a ligament link |
US9414833B2 (en) | 2006-02-03 | 2016-08-16 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US9421008B2 (en) * | 2011-09-23 | 2016-08-23 | Arthrex, Inc. | Soft suture-based anchors |
US9445827B2 (en) | 2011-10-25 | 2016-09-20 | Biomet Sports Medicine, Llc | Method and apparatus for intraosseous membrane reconstruction |
US9445803B2 (en) | 2011-11-23 | 2016-09-20 | Howmedica Osteonics Corp. | Filamentary suture anchor |
US9463013B2 (en) | 2013-03-13 | 2016-10-11 | Stryker Corporation | Adjustable continuous filament structure and method of manufacture and use |
US9480475B2 (en) | 2012-08-15 | 2016-11-01 | DePuy Synthes Products, Inc. | Bone plate suture anchor |
US9486211B2 (en) | 2006-09-29 | 2016-11-08 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US9492158B2 (en) | 2006-02-03 | 2016-11-15 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9504460B2 (en) | 2004-11-05 | 2016-11-29 | Biomet Sports Medicine, LLC. | Soft tissue repair device and method |
US9510819B2 (en) | 2006-02-03 | 2016-12-06 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US9532777B2 (en) | 2006-02-03 | 2017-01-03 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9539003B2 (en) | 2006-09-29 | 2017-01-10 | Biomet Sports Medicine, LLC. | Method and apparatus for forming a self-locking adjustable loop |
US9538998B2 (en) | 2006-02-03 | 2017-01-10 | Biomet Sports Medicine, Llc | Method and apparatus for fracture fixation |
US9572655B2 (en) | 2004-11-05 | 2017-02-21 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US20170049432A1 (en) * | 2015-08-20 | 2017-02-23 | Arthrex, Inc. | Tensionable contructs with multi-limb locking mechanism through single splice and methods of tissue repair |
US20170055975A1 (en) * | 2015-09-02 | 2017-03-02 | Raymond Thal | Adjustable, locking all-suture anchor assembly and method for repair |
US20170071590A1 (en) * | 2015-09-10 | 2017-03-16 | Suture Armor Llc | Suture anchor |
US9597064B2 (en) | 2010-04-27 | 2017-03-21 | DePuy Synthes Products, Inc. | Methods for approximating a tissue defect using an anchor assembly |
US9603591B2 (en) | 2006-02-03 | 2017-03-28 | Biomet Sports Medicine, Llc | Flexible anchors for tissue fixation |
US9615822B2 (en) | 2014-05-30 | 2017-04-11 | Biomet Sports Medicine, Llc | Insertion tools and method for soft anchor |
US20170119369A1 (en) * | 2011-05-06 | 2017-05-04 | Linvatec Corporation | Soft anchor made from suture filament and suture tape |
US9642661B2 (en) | 2006-02-03 | 2017-05-09 | Biomet Sports Medicine, Llc | Method and Apparatus for Sternal Closure |
US9681940B2 (en) | 2006-09-29 | 2017-06-20 | Biomet Sports Medicine, Llc | Ligament system for knee joint |
US9681864B1 (en) | 2014-01-03 | 2017-06-20 | Harpoon Medical, Inc. | Method and apparatus for transapical procedures on a mitral valve |
US9700291B2 (en) | 2014-06-03 | 2017-07-11 | Biomet Sports Medicine, Llc | Capsule retractor |
US20170202669A1 (en) * | 2014-07-17 | 2017-07-20 | Coremedic Ag | Medical apparatus and method for heart valve repair |
US9724090B2 (en) | 2006-09-29 | 2017-08-08 | Biomet Manufacturing, Llc | Method and apparatus for attaching soft tissue to bone |
US9737293B2 (en) | 2013-03-15 | 2017-08-22 | Medos International Sàrl | Surgical constructs with collapsing suture loop and methods for securing tissue |
US9743919B2 (en) * | 2010-04-27 | 2017-08-29 | DePuy Synthes Products, Inc. | Stitch lock for attaching two or more structures |
US9757113B2 (en) | 2013-07-31 | 2017-09-12 | Medos International Sàrl | Adjustable graft fixation device |
US9757119B2 (en) | 2013-03-08 | 2017-09-12 | Biomet Sports Medicine, Llc | Visual aid for identifying suture limbs arthroscopically |
US9763655B2 (en) | 2012-09-20 | 2017-09-19 | Medos International Sarl | Systems, devices, and methods for securing tissue using hard anchors |
US9763656B2 (en) | 2006-02-03 | 2017-09-19 | Biomet Sports Medicine, Llc | Method and apparatus for soft tissue fixation |
US9763719B2 (en) | 2010-08-17 | 2017-09-19 | Redyns Medical Llc | Method and apparatus for attaching soft tissue to bone |
US9788826B2 (en) | 2013-03-11 | 2017-10-17 | Howmedica Osteonics Corp. | Filamentary fixation device and assembly and method of assembly, manufacture and use |
US9788876B2 (en) | 2006-09-29 | 2017-10-17 | Biomet Sports Medicine, Llc | Fracture fixation device |
US9801708B2 (en) | 2004-11-05 | 2017-10-31 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9801620B2 (en) | 2006-02-03 | 2017-10-31 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to bone |
US9808242B2 (en) | 2012-04-06 | 2017-11-07 | Howmedica Osteonics Corp. | Knotless filament anchor for soft tissue repair |
US9888998B2 (en) | 2016-01-19 | 2018-02-13 | DePuy Synthes Products, Inc. | Flexible implant with adjustable coils |
US9918827B2 (en) | 2013-03-14 | 2018-03-20 | Biomet Sports Medicine, Llc | Scaffold for spring ligament repair |
US9918826B2 (en) | 2006-09-29 | 2018-03-20 | Biomet Sports Medicine, Llc | Scaffold for spring ligament repair |
US9949733B1 (en) | 2014-01-03 | 2018-04-24 | Cayenne Medical, Inc. | All-suture suture anchor systems and methods |
US20180110605A1 (en) * | 2016-10-21 | 2018-04-26 | Sofradim Production | Method for forming a mesh having a barbed suture attached thereto and the mesh thus obtained |
US9955980B2 (en) | 2015-02-24 | 2018-05-01 | Biomet Sports Medicine, Llc | Anatomic soft tissue repair |
US9962149B2 (en) | 2011-11-14 | 2018-05-08 | Arthrocare Corporation | Tissue repair assembly |
US9962150B2 (en) | 2013-12-20 | 2018-05-08 | Arthrocare Corporation | Knotless all suture tissue repair |
US9974643B2 (en) | 2013-03-11 | 2018-05-22 | Medos International Sàrl | Implant having adjustable filament coils |
US9986992B2 (en) | 2014-10-28 | 2018-06-05 | Stryker Corporation | Suture anchor and associated methods of use |
US9993240B2 (en) | 2014-02-12 | 2018-06-12 | Roy H. Trawick | Meniscal repair device |
US10039543B2 (en) | 2014-08-22 | 2018-08-07 | Biomet Sports Medicine, Llc | Non-sliding soft anchor |
US10052094B2 (en) | 2013-03-11 | 2018-08-21 | Medos International Sàrl | Implant having adjustable filament coils |
US10136886B2 (en) | 2013-12-20 | 2018-11-27 | Biomet Sports Medicine, Llc | Knotless soft tissue devices and techniques |
US10182806B2 (en) | 2013-03-12 | 2019-01-22 | Arthrocare Corporation | Tissue repair assembly |
CN109394284A (en) * | 2017-08-17 | 2019-03-01 | 北京德益达美医疗科技有限公司 | All fronts holdfast |
US10231744B2 (en) | 2009-08-20 | 2019-03-19 | Howmedica Osteonics Corp. | Flexible ACL instrumentation, kit and method |
US10307154B2 (en) | 2016-09-27 | 2019-06-04 | Arthrex, Inc. | Circular suture constructs and methods for use |
US20190231338A1 (en) * | 2018-01-31 | 2019-08-01 | Arthrex, Inc. | Active deploying soft anchor |
US10405968B2 (en) | 2013-12-11 | 2019-09-10 | Medos International Sarl | Implant having filament limbs of an adjustable loop disposed in a shuttle suture |
US10499904B2 (en) * | 2015-02-17 | 2019-12-10 | Smith & Nephew, Inc. | Anchor insertion system and method of use thereof |
US10517587B2 (en) | 2006-02-03 | 2019-12-31 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US10543090B2 (en) | 2016-12-30 | 2020-01-28 | Pipeline Medical Technologies, Inc. | Neo chordae tendinae deployment system |
US10568616B2 (en) | 2014-12-17 | 2020-02-25 | Howmedica Osteonics Corp. | Instruments and methods of soft tissue fixation |
US10610211B2 (en) | 2013-12-12 | 2020-04-07 | Howmedica Osteonics Corp. | Filament engagement system and methods of use |
US10624743B2 (en) | 2016-04-22 | 2020-04-21 | Edwards Lifesciences Corporation | Beating-heart mitral valve chordae replacement |
US10667910B2 (en) | 2016-12-30 | 2020-06-02 | Pipeline Medical Technologies, Inc. | Method and apparatus for transvascular implantation of neo chordae tendinae |
US10765515B2 (en) | 2017-04-06 | 2020-09-08 | University Of Maryland, Baltimore | Distal anchor apparatus and methods for mitral valve repair |
USD902405S1 (en) | 2018-02-22 | 2020-11-17 | Stryker Corporation | Self-punching bone anchor inserter |
US10864080B2 (en) | 2015-10-02 | 2020-12-15 | Harpoon Medical, Inc. | Distal anchor apparatus and methods for mitral valve repair |
US10912551B2 (en) | 2015-03-31 | 2021-02-09 | Biomet Sports Medicine, Llc | Suture anchor with soft anchor of electrospun fibers |
US10925731B2 (en) | 2016-12-30 | 2021-02-23 | Pipeline Medical Technologies, Inc. | Method and apparatus for transvascular implantation of neo chordae tendinae |
US11026672B2 (en) | 2017-06-19 | 2021-06-08 | Harpoon Medical, Inc. | Method and apparatus for cardiac procedures |
US20210186484A1 (en) * | 2014-03-05 | 2021-06-24 | Cayenne Medical, Inc. | All-suture suture anchor systems and methods |
US11065120B2 (en) | 2017-10-24 | 2021-07-20 | University Of Maryland, Baltimore | Method and apparatus for cardiac procedures |
US11076844B2 (en) * | 2012-05-03 | 2021-08-03 | Riverpoint Medical, Llc | Soft suture anchor |
US11259792B2 (en) | 2006-02-03 | 2022-03-01 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US11259794B2 (en) | 2006-09-29 | 2022-03-01 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US11311287B2 (en) | 2006-02-03 | 2022-04-26 | Biomet Sports Medicine, Llc | Method for tissue fixation |
CN114469217A (en) * | 2022-02-09 | 2022-05-13 | 运医之星(上海)科技有限公司 | Meniscus sewing system and manufacturing method |
US11331094B2 (en) | 2013-04-22 | 2022-05-17 | Stryker Corporation | Method and apparatus for attaching tissue to bone |
US11426157B2 (en) * | 2018-05-30 | 2022-08-30 | Aju Pharm Co., Ltd. | Method of preparing suture anchor using suture and prepared suture anchor |
US11517435B2 (en) | 2018-05-04 | 2022-12-06 | Edwards Lifesciences Corporation | Ring-based prosthetic cardiac valve |
US11696828B2 (en) | 2016-12-30 | 2023-07-11 | Pipeline Medical Technologies, Inc. | Method and apparatus for mitral valve chord repair |
CN116509468A (en) * | 2023-03-13 | 2023-08-01 | 杭州德诺电生理医疗科技有限公司 | Plugging system and knotting method of tightening piece |
US11819204B2 (en) | 2020-11-13 | 2023-11-21 | Raymond Thal | Adjustable all-suture anchoring assembly and method |
US12096929B2 (en) | 2023-06-21 | 2024-09-24 | Smith & Nephew, Inc. | Flexible anchor delivery system |
Families Citing this family (32)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10568628B2 (en) * | 2017-05-23 | 2020-02-25 | Muffin Incorporated | Closing device for tissue openings |
US9775596B2 (en) | 2010-09-17 | 2017-10-03 | DePuy Synthes Products, Inc. | Device for anchoring a suture |
AU2012267924B2 (en) * | 2011-06-07 | 2016-08-11 | Smith & Nephew, Inc. | Surgical anchor delivery system |
JP6231546B2 (en) | 2012-03-13 | 2017-11-15 | スミス アンド ネフュー インコーポレーテッドSmith & Nephew,Inc. | Surgical needle |
US9421010B2 (en) | 2012-06-20 | 2016-08-23 | Arthrex, Inc. | Whipping suture anchor |
US9463011B2 (en) | 2012-08-17 | 2016-10-11 | Arthrex, Inc. | Soft anchors with soft eyelets |
EP2967645A1 (en) | 2013-03-15 | 2016-01-20 | Smith & Nephew, Inc. | Surgical needle |
US20140276986A1 (en) * | 2013-03-15 | 2014-09-18 | Carine Hoarau | Anastomotic device and method |
WO2016061044A1 (en) | 2014-10-15 | 2016-04-21 | Smith & Nephew, Inc. | Anchor/ implant deployment device and tissue repair methods relate thereto |
US10945737B2 (en) | 2015-10-29 | 2021-03-16 | Axogen Corporation | Implant devices with a pre-set pulley system |
EP3429480B1 (en) * | 2016-03-18 | 2020-06-17 | Smith & Nephew, Inc | Surgical fixation device |
US10709435B2 (en) | 2016-04-20 | 2020-07-14 | Medos International Sarl | Meniscal repair devices, systems, and methods |
US10932769B2 (en) * | 2016-05-26 | 2021-03-02 | Ivy Sports Medicine, Llc | System and method for all-inside suture fixation for implant attachment and soft tissue repair |
EP3534803B1 (en) | 2016-11-03 | 2022-01-05 | Smith & Nephew, Inc | Tissue repair assembly and system with soft anchoring implant |
TWI601510B (en) * | 2016-11-07 | 2017-10-11 | 國立成功大學 | Bendable surgical instrument for suturing meniscus |
US10245020B2 (en) * | 2017-03-13 | 2019-04-02 | Medos International Sarl | Methods and systems for knotless suture anchoring |
WO2018187753A1 (en) * | 2017-04-06 | 2018-10-11 | Harpoon Medical, Inc. | Distal anchor apparatus and methods for mitral valve repair |
US12059148B2 (en) | 2017-06-05 | 2024-08-13 | Conmed Corporation | Suture system and related methods for connecting and creating suspension between at least two bodies |
US11911019B2 (en) | 2017-07-13 | 2024-02-27 | Conmed Corporation | All-suture anchor |
US11534154B2 (en) | 2017-08-31 | 2022-12-27 | Medos International Sarl | Devices and methods for tissue repair |
US20200383679A1 (en) | 2017-11-27 | 2020-12-10 | T.A.G. Medical Devices - Agriculture Cooperative Ltd. | Multiple anchor delivery system and method |
JP7081287B2 (en) * | 2018-05-01 | 2022-06-07 | ブラザー工業株式会社 | Suture device |
JP7471234B2 (en) * | 2018-05-17 | 2024-04-19 | スミス アンド ネフュー インコーポレイテッド | Tissue repair devices and methods |
WO2019236468A1 (en) * | 2018-06-04 | 2019-12-12 | West Gen Technologies, L.L.C. | Fixation device cartridges |
FR3094625A1 (en) * | 2019-04-02 | 2020-10-09 | Jean-Luc Raynier | Device for reinserting soft tissue to a bone support |
EP3738520B1 (en) * | 2019-05-16 | 2024-01-24 | Smith & Nephew, Inc. | Tissue repair assembly |
CN111388040B (en) * | 2020-03-25 | 2021-04-09 | 李晋 | Half-moon plate sewing crochet hook for orthopedic operation |
US20220151603A1 (en) * | 2020-11-13 | 2022-05-19 | Siesta Medical, Inc. | Anchoring systems and methods |
AU2022318222A1 (en) | 2021-07-26 | 2024-03-14 | Medos International Sarl | Suture having adaptable surface characteristics, and related systems and methods |
CN114652379B (en) * | 2022-03-16 | 2023-09-05 | 上海利格泰生物科技股份有限公司 | Fixing device, manufacturing method thereof and medical fixing device |
CN115300018A (en) * | 2022-06-20 | 2022-11-08 | 孟庆广 | Tendon suture device and method |
CN116421241B (en) * | 2023-06-08 | 2023-08-22 | 北京万洁天元医疗器械股份有限公司 | Meniscus injury repair device |
Citations (87)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US113548A (en) * | 1871-04-11 | Improvement in folding table-tops | ||
US148913A (en) * | 1874-03-24 | Improvement in governors | ||
US149490A (en) * | 1874-04-07 | Improvement in permutation-locks | ||
US154969A (en) * | 1874-09-15 | Improvement in spinning-wheels | ||
US161085A (en) * | 1875-03-23 | Improvement in steam-radiators | ||
US263343A (en) * | 1882-08-29 | Tread for horse powers | ||
US386728A (en) * | 1888-07-24 | db long | ||
US453120A (en) * | 1891-05-26 | Furnace for roasting ores | ||
US3580256A (en) * | 1969-06-30 | 1971-05-25 | Jack E Wilkinson | Pre-tied suture and method of suturing |
US4006747A (en) * | 1975-04-23 | 1977-02-08 | Ethicon, Inc. | Surgical method |
US4669473A (en) * | 1985-09-06 | 1987-06-02 | Acufex Microsurgical, Inc. | Surgical fastener |
US4741330A (en) * | 1983-05-19 | 1988-05-03 | Hayhurst John O | Method and apparatus for anchoring and manipulating cartilage |
US4994028A (en) * | 1987-03-18 | 1991-02-19 | Endocon, Inc. | Injector for inplanting multiple pellet medicaments |
US5041129A (en) * | 1990-07-02 | 1991-08-20 | Acufex Microsurgical, Inc. | Slotted suture anchor and method of anchoring a suture |
US5156616A (en) * | 1992-02-10 | 1992-10-20 | Meadows Bruce F | Apparatus and method for suture attachment |
US5417691A (en) * | 1982-05-20 | 1995-05-23 | Hayhurst; John O. | Apparatus and method for manipulating and anchoring tissue |
US5540703A (en) * | 1993-01-06 | 1996-07-30 | Smith & Nephew Richards Inc. | Knotted cable attachment apparatus formed of braided polymeric fibers |
US5562684A (en) * | 1994-10-11 | 1996-10-08 | Ethicon, Inc. | Surgical knot pusher device and improved method of forming knots |
US5562736A (en) * | 1994-10-17 | 1996-10-08 | Raymedica, Inc. | Method for surgical implantation of a prosthetic spinal disc nucleus |
US5601557A (en) * | 1982-05-20 | 1997-02-11 | Hayhurst; John O. | Anchoring and manipulating tissue |
US5626614A (en) * | 1995-12-22 | 1997-05-06 | Applied Medical Resources Corporation | T-anchor suturing device and method for using same |
US5643319A (en) * | 1991-05-13 | 1997-07-01 | United States Surgical Corporation | Device for applying a meniscal staple |
US5824093A (en) * | 1994-10-17 | 1998-10-20 | Raymedica, Inc. | Prosthetic spinal disc nucleus |
US5944739A (en) * | 1998-03-12 | 1999-08-31 | Surgical Dynamics, Inc. | Suture anchor installation system |
US5951590A (en) * | 1998-06-09 | 1999-09-14 | Goldfarb; Michael A. | Soft tissue suture anchor |
US5957953A (en) * | 1996-02-16 | 1999-09-28 | Smith & Nephew, Inc. | Expandable suture anchor |
US5970697A (en) * | 1997-04-24 | 1999-10-26 | Jacobs; William J. B. | Line with double spliced loops |
US6110183A (en) * | 1998-12-22 | 2000-08-29 | Cook Incorporated | Suture anchor device |
US6224630B1 (en) * | 1998-05-29 | 2001-05-01 | Advanced Bio Surfaces, Inc. | Implantable tissue repair device |
US6245107B1 (en) * | 1999-05-28 | 2001-06-12 | Bret A. Ferree | Methods and apparatus for treating disc herniation |
US6296659B1 (en) * | 2000-02-29 | 2001-10-02 | Opus Medical, Inc. | Single-tailed suturing method and apparatus |
US6306159B1 (en) * | 1998-12-23 | 2001-10-23 | Depuy Orthopaedics, Inc. | Meniscal repair device |
US20020065536A1 (en) * | 1999-08-30 | 2002-05-30 | Applied Medical Resources Corporation | Surgical clip |
US6432123B2 (en) * | 1998-12-30 | 2002-08-13 | Ethicon, Inc. | Suture locking device |
US20020115999A1 (en) * | 1999-07-23 | 2002-08-22 | Mcdevitt Dennis | System and method for attaching soft tissue to bone |
US6508839B1 (en) * | 1999-08-18 | 2003-01-21 | Intrinsic Orthopedics, Inc. | Devices and methods of vertebral disc augmentation |
US6530933B1 (en) * | 1998-12-31 | 2003-03-11 | Teresa T. Yeung | Methods and devices for fastening bulging or herniated intervertebral discs |
US6579291B1 (en) * | 2000-10-10 | 2003-06-17 | Spinalabs, Llc | Devices and methods for the treatment of spinal disorders |
US20030167071A1 (en) * | 2002-03-01 | 2003-09-04 | Evalve, Inc. | Suture fasteners and methods of use |
US6689125B1 (en) * | 2000-04-04 | 2004-02-10 | Spinalabs, Llc | Devices and methods for the treatment of spinal disorders |
US6719797B1 (en) * | 1999-08-13 | 2004-04-13 | Bret A. Ferree | Nucleus augmentation with in situ formed hydrogels |
US20040097980A1 (en) * | 1999-05-28 | 2004-05-20 | Ferree Bret A. | Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft |
US6758855B2 (en) * | 1998-08-19 | 2004-07-06 | Artemis Medical, Inc. | Target tissue localization device |
US20040153074A1 (en) * | 2003-02-05 | 2004-08-05 | Bojarski Raymond A. | Tissue anchor and insertion tool |
US20040162618A1 (en) * | 2003-02-14 | 2004-08-19 | Centerpulse Spine-Tech, Inc. | Expandable intervertebral implant cage |
US20050080422A1 (en) * | 2003-10-14 | 2005-04-14 | Centerpulse Spine-Tech, Inc. | Instruments for use with implants, and methods |
US6972027B2 (en) * | 2002-06-26 | 2005-12-06 | Stryker Endoscopy | Soft tissue repair system |
US20050277966A1 (en) * | 2004-06-09 | 2005-12-15 | Usgi Medical Inc. | Compressible tissue anchor assemblies |
US7004970B2 (en) * | 1999-10-20 | 2006-02-28 | Anulex Technologies, Inc. | Methods and devices for spinal disc annulus reconstruction and repair |
US7033393B2 (en) * | 2002-06-27 | 2006-04-25 | Raymedica, Inc. | Self-transitioning spinal disc anulus occulsion device and method of use |
US20060178680A1 (en) * | 2005-02-07 | 2006-08-10 | Regen Biologics, Inc. | System and method for all-inside suture fixation for implant attachment and soft tissue repair |
US20060265008A1 (en) * | 2005-05-18 | 2006-11-23 | Terumo Kabushiki Kaisha | Tissue closing device |
US20070010857A1 (en) * | 2005-07-05 | 2007-01-11 | Mitralign, Inc. | Tissue anchor, anchoring system and methods of using the same |
US20070027476A1 (en) * | 2005-02-07 | 2007-02-01 | Regen Biologics, Inc. | System and method for all-inside suture fixation for implant attachment and soft tissue repair |
US20070100348A1 (en) * | 1999-10-20 | 2007-05-03 | Cauthen Joseph C Iii | Apparatus and methods for the treatment of the intervertebral disc |
US20070129804A1 (en) * | 2005-12-07 | 2007-06-07 | Zimmer Spine, Inc. | Transforaminal lumbar interbody fusion spacers |
US20070156245A1 (en) * | 1999-10-20 | 2007-07-05 | Cauthen Joseph C Iii | Method and apparatus for the treatment of the intervertebral disc annulus |
US20080009888A1 (en) * | 2006-07-07 | 2008-01-10 | Usgi Medical, Inc. | Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use |
US7335221B2 (en) * | 2002-04-12 | 2008-02-26 | Ethicon, Inc. | Suture anchoring and tensioning device and method for using same |
US7347863B2 (en) * | 2004-05-07 | 2008-03-25 | Usgi Medical, Inc. | Apparatus and methods for manipulating and securing tissue |
US20080140093A1 (en) * | 2006-02-03 | 2008-06-12 | Stone Kevin T | Soft tissue repair device and associated methods |
US7390332B2 (en) * | 2004-02-24 | 2008-06-24 | Depuy Mitek, Inc. | Methods and devices for repairing tissue |
US20080177304A1 (en) * | 2004-09-29 | 2008-07-24 | Usgi Medical, Inc. | Apparatus for grasping and cinching tissue anchors |
US20080195145A1 (en) * | 2007-02-13 | 2008-08-14 | Bonutti Peter M | Tissue fixation system and method |
US20090069823A1 (en) * | 2007-09-12 | 2009-03-12 | Foerster Seth A | Implant and delivery system for soft tissue repair |
US20090082805A1 (en) * | 2006-09-29 | 2009-03-26 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US20090228042A1 (en) * | 2008-03-04 | 2009-09-10 | Koogle Jr David C | Method and system for meniscal repair using suture implant cinch construct |
US7621925B2 (en) * | 2004-05-07 | 2009-11-24 | Usgi Medical, Inc. | Needle assembly for tissue manipulation |
US20090306711A1 (en) * | 2006-02-03 | 2009-12-10 | Biomet Sports Medicine, Llc | Method for Tissue Fixation |
US7651509B2 (en) * | 1999-12-02 | 2010-01-26 | Smith & Nephew, Inc. | Methods and devices for tissue repair |
US20100049212A1 (en) * | 2008-04-02 | 2010-02-25 | David Caborn | Method and apparatus for meniscal repair |
US7670379B2 (en) * | 1999-10-20 | 2010-03-02 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method |
US7678135B2 (en) * | 2004-06-09 | 2010-03-16 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
US20100094425A1 (en) * | 2008-10-14 | 2010-04-15 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US7731732B2 (en) * | 2007-08-31 | 2010-06-08 | Ken Christopher G M | Closure medical device |
US7749250B2 (en) * | 2006-02-03 | 2010-07-06 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US7753941B2 (en) * | 2000-04-04 | 2010-07-13 | Anulex Technologies, Inc. | Devices and methods for annular repair of intervertebral discs |
US20110022084A1 (en) * | 2009-07-24 | 2011-01-27 | Mehmet Ziya Sengun | Methods and devices for repairing and anchoring damaged tissue |
US7905904B2 (en) * | 2006-02-03 | 2011-03-15 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US7922768B2 (en) * | 1999-10-20 | 2011-04-12 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and deformable spinal disc annulus stent |
US8083768B2 (en) * | 2000-12-14 | 2011-12-27 | Ensure Medical, Inc. | Vascular plug having composite construction |
US20120004669A1 (en) * | 2010-04-27 | 2012-01-05 | Tom Overes | Insertion instrument for anchor assembly |
US20120035654A1 (en) * | 2009-03-14 | 2012-02-09 | Vasostitch, Inc. | Methods and systems for advancing and anchoring suture in tissue |
US20120046693A1 (en) * | 2006-02-03 | 2012-02-23 | Biomet Sports Medicine, Llc | Method and Apparatus for Forming a Self-Locking Adjustable Loop |
US20120109156A1 (en) * | 2010-04-27 | 2012-05-03 | Tom Overes | Methods for approximating a tissue defect using an anchor assembly |
US20120130422A1 (en) * | 2010-11-24 | 2012-05-24 | Arthrocare Corporation | Novel suture |
US20120150223A1 (en) * | 2010-04-27 | 2012-06-14 | Jamie Manos | Stitch lock for attaching two or more structures |
Family Cites Families (155)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US330087A (en) | 1885-11-10 | Endless band or cord | ||
US261501A (en) | 1882-07-18 | Bag and sail tie | ||
US233475A (en) | 1880-10-19 | l vandermark | ||
US400743A (en) | 1889-04-02 | Lamp-extinguisher | ||
US2490364A (en) | 1948-02-27 | 1949-12-06 | Herman H Livingston | Bone pin |
CA992255A (en) | 1971-01-25 | 1976-07-06 | Cutter Laboratories | Prosthesis for spinal repair |
US3908677A (en) | 1974-12-12 | 1975-09-30 | Delore A Beach | Dental floss holder |
US3987806A (en) | 1975-03-24 | 1976-10-26 | Gilbert Phylis L | Dental floss applicator |
US4235238A (en) | 1978-05-11 | 1980-11-25 | Olympus Optical Co., Ltd. | Apparatus for suturing coeliac tissues |
US6656182B1 (en) | 1982-05-20 | 2003-12-02 | John O. Hayhurst | Tissue manipulation |
US4778990A (en) | 1987-02-06 | 1988-10-18 | Varo, Inc. | Radiant energy receiving and directing apparatus and method |
US4788990A (en) | 1987-04-09 | 1988-12-06 | Wisegerber Lester R | Flosser locking mechanism |
US5478353A (en) | 1987-05-14 | 1995-12-26 | Yoon; Inbae | Suture tie device system and method for suturing anatomical tissue proximate an opening |
US5053046A (en) | 1988-08-22 | 1991-10-01 | Woodrow W. Janese | Dural sealing needle and method of use |
US4994069A (en) * | 1988-11-02 | 1991-02-19 | Target Therapeutics | Vaso-occlusion coil and method |
JPH0692078B2 (en) | 1988-12-15 | 1994-11-16 | 株式会社貝印刃物開発センター | Coated blade |
US5062344A (en) | 1990-04-12 | 1991-11-05 | Sparton Corporation | Bowline knot in a braided line |
US5021059A (en) | 1990-05-07 | 1991-06-04 | Kensey Nash Corporation | Plug device with pulley for sealing punctures in tissue and methods of use |
US5269809A (en) | 1990-07-02 | 1993-12-14 | American Cyanamid Company | Locking mechanism for use with a slotted suture anchor |
US5129912B2 (en) * | 1991-01-07 | 2000-01-11 | Urohealth Systems Inc | Device and method for applying suture |
US5281238A (en) | 1991-11-22 | 1994-01-25 | Chin Albert K | Endoscopic ligation instrument |
DE4207854A1 (en) | 1992-03-12 | 1993-09-16 | Klemm Bernd | Preformed surgical thread for easy knotting - thread has elastic section with preformed loops in opposite-handed pairs part of length or end of thread is passed through loop to form knot |
US5549630A (en) | 1993-05-14 | 1996-08-27 | Bonutti; Peter M. | Method and apparatus for anchoring a suture |
US5403348A (en) | 1993-05-14 | 1995-04-04 | Bonutti; Peter M. | Suture anchor |
US5464426A (en) | 1993-05-14 | 1995-11-07 | Bonutti; Peter M. | Method of closing discontinuity in tissue |
US5507754A (en) | 1993-08-20 | 1996-04-16 | United States Surgical Corporation | Apparatus and method for applying and adjusting an anchoring device |
US5571189A (en) | 1994-05-20 | 1996-11-05 | Kuslich; Stephen D. | Expandable fabric implant for stabilizing the spinal motion segment |
AU2621295A (en) | 1994-05-24 | 1995-12-18 | Smith & Nephew Plc | Intervertebral disc implant |
US5649945A (en) | 1994-10-17 | 1997-07-22 | Raymedica, Inc. | Spinal anulus cutter |
US6638291B1 (en) * | 1995-04-20 | 2003-10-28 | Micrus Corporation | Three dimensional, low friction vasoocclusive coil, and method of manufacture |
US5702462A (en) | 1996-01-24 | 1997-12-30 | Oberlander; Michael | Method of meniscal repair |
US5699657A (en) | 1996-05-23 | 1997-12-23 | Paulson; William Thomas | Braided line splices and methods of splicing to form same |
US5948000A (en) | 1996-10-03 | 1999-09-07 | United States Surgical Corporation | System for suture anchor placement |
CA2217406C (en) | 1996-10-04 | 2006-05-30 | United States Surgical Corporation | Suture anchor installation system with disposable loading unit |
US5948002A (en) | 1996-11-15 | 1999-09-07 | Bonutti; Peter M. | Apparatus and method for use in positioning a suture anchor |
FR2760185B1 (en) | 1997-02-28 | 1999-05-14 | Laurent Fumex | SURGICAL BONE AND ANCILLARY ANCHORING DEVICE FOR ITS PLACEMENT |
US5728109A (en) | 1997-04-08 | 1998-03-17 | Ethicon Endo-Surgery, Inc. | Surgical knot and method for its formation |
US5906626A (en) | 1997-08-07 | 1999-05-25 | Carrillo; Hipolito | Suture depressor |
US5944724A (en) | 1997-10-30 | 1999-08-31 | Mitek Surgical Products, Inc. | Suture anchor insertion system |
US6068648A (en) | 1998-01-26 | 2000-05-30 | Orthodyne, Inc. | Tissue anchoring system and method |
FR2774580B1 (en) | 1998-02-06 | 2000-09-08 | Laurent Fumex | BONE ANCHORING SURGICAL DEVICE |
US6113611A (en) | 1998-05-28 | 2000-09-05 | Advanced Vascular Technologies, Llc | Surgical fastener and delivery system |
US6146422A (en) | 1999-01-25 | 2000-11-14 | Lawson; Kevin Jon | Prosthetic nucleus replacement for surgical reconstruction of intervertebral discs and treatment method |
US6991643B2 (en) | 2000-12-20 | 2006-01-31 | Usgi Medical Inc. | Multi-barbed device for retaining tissue in apposition and methods of use |
US7416554B2 (en) | 2002-12-11 | 2008-08-26 | Usgi Medical Inc | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US7744613B2 (en) | 1999-06-25 | 2010-06-29 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US20040122456A1 (en) | 2002-12-11 | 2004-06-24 | Saadat Vahid C. | Methods and apparatus for gastric reduction |
US7128708B2 (en) | 2002-06-13 | 2006-10-31 | Usgi Medical Inc. | Shape lockable apparatus and method for advancing an instrument through unsupported anatomy |
US6425919B1 (en) | 1999-08-18 | 2002-07-30 | Intrinsic Orthopedics, Inc. | Devices and methods of vertebral disc augmentation |
US6964674B1 (en) | 1999-09-20 | 2005-11-15 | Nuvasive, Inc. | Annulotomy closure device |
US20050256582A1 (en) | 1999-10-08 | 2005-11-17 | Ferree Bret A | Spinal implants, including devices that reduce pressure on the annulus fibrosis |
US7935147B2 (en) | 1999-10-20 | 2011-05-03 | Anulex Technologies, Inc. | Method and apparatus for enhanced delivery of treatment device to the intervertebral disc annulus |
US7951201B2 (en) | 1999-10-20 | 2011-05-31 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US8128698B2 (en) | 1999-10-20 | 2012-03-06 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US20030153976A1 (en) | 1999-10-20 | 2003-08-14 | Cauthen Joseph C. | Spinal disc annulus reconstruction method and spinal disc annulus stent |
US7153312B1 (en) | 1999-12-02 | 2006-12-26 | Smith & Nephew Inc. | Closure device and method for tissue repair |
US6746483B1 (en) | 2000-03-16 | 2004-06-08 | Smith & Nephew, Inc. | Sheaths for implantable fixation devices |
US6209550B1 (en) | 2000-06-20 | 2001-04-03 | Walter J. Powell, Jr. | Flossing tool |
US6588426B2 (en) | 2000-08-31 | 2003-07-08 | Craig D. Linderoth | Tracheostomy safety device |
EP1231537A1 (en) | 2001-02-09 | 2002-08-14 | Siemens Aktiengesellschaft | Automatic turn-on of a computer cluster after a curable failure |
US20020188301A1 (en) | 2001-06-11 | 2002-12-12 | Dallara Mark Douglas | Tissue anchor insertion system |
US20050027307A1 (en) | 2001-07-16 | 2005-02-03 | Schwartz Herbert Eugene | Unitary surgical device and method |
US6767037B2 (en) * | 2001-09-27 | 2004-07-27 | Depuy Mitek, Inc. | Sliding and locking surgical knot |
US7122039B2 (en) | 2002-05-01 | 2006-10-17 | Boston Scientific Scimed, Inc. | Tying knots |
GB0211378D0 (en) | 2002-05-17 | 2002-06-26 | Univ London | A device for transfixing and joining tissue |
US7494496B2 (en) | 2002-05-17 | 2009-02-24 | Ucl Biomedica Plc | Device for transfixing and joining tissue |
US7666193B2 (en) | 2002-06-13 | 2010-02-23 | Guided Delivery Sytems, Inc. | Delivery devices and methods for heart valve repair |
US7041052B2 (en) | 2002-06-13 | 2006-05-09 | Usgi Medical Inc. | Shape lockable apparatus and method for advancing an instrument through unsupported anatomy |
US6986775B2 (en) | 2002-06-13 | 2006-01-17 | Guided Delivery Systems, Inc. | Devices and methods for heart valve repair |
US20050228406A1 (en) | 2002-07-03 | 2005-10-13 | Bose Ganendra C | Formation of knots |
CA2492700C (en) | 2002-07-31 | 2010-10-12 | Abbott Laboratories Vascular Enterprises, Limited | Apparatus for sealing surgical punctures |
US7303575B2 (en) | 2002-08-01 | 2007-12-04 | Lumen Biomedical, Inc. | Embolism protection devices |
US7942898B2 (en) * | 2002-12-11 | 2011-05-17 | Usgi Medical, Inc. | Delivery systems and methods for gastric reduction |
US7491212B2 (en) | 2003-02-19 | 2009-02-17 | Smith & Nephew, Inc. | Transmitting an actuating force along a curved instrument |
US6960208B2 (en) | 2003-06-30 | 2005-11-01 | Boston Scientific Scimed, Inc. | Apparatus and methods for delivering energy to a target site within bone |
US20050049634A1 (en) | 2003-08-07 | 2005-03-03 | Scimed Life Systems, Inc. | Medical closure device |
JP4482640B2 (en) | 2003-10-28 | 2010-06-16 | 学校法人日本大学 | Suture transfer device |
US7361180B2 (en) | 2004-05-07 | 2008-04-22 | Usgi Medical, Inc. | Apparatus for manipulating and securing tissue |
US8864822B2 (en) | 2003-12-23 | 2014-10-21 | Mitralign, Inc. | Devices and methods for introducing elements into tissue |
US7329279B2 (en) | 2003-12-23 | 2008-02-12 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a patient's heart valve |
US20050159762A1 (en) | 2003-12-30 | 2005-07-21 | Juha-Pekka Nuutinen | Suture arrow device and installation device |
US20080039873A1 (en) | 2004-03-09 | 2008-02-14 | Marctec, Llc. | Method and device for securing body tissue |
US7658750B2 (en) | 2004-03-18 | 2010-02-09 | Warsaw Orthopedic, Inc. | Suture anchoring system and method |
JP4643328B2 (en) | 2004-04-07 | 2011-03-02 | オリンパス株式会社 | Medical ligature suturing device |
US8425539B2 (en) | 2004-04-12 | 2013-04-23 | Xlumena, Inc. | Luminal structure anchoring devices and methods |
US20050251208A1 (en) | 2004-05-07 | 2005-11-10 | Usgi Medical Inc. | Linear anchors for anchoring to tissue |
US8257394B2 (en) | 2004-05-07 | 2012-09-04 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
US8444657B2 (en) | 2004-05-07 | 2013-05-21 | Usgi Medical, Inc. | Apparatus and methods for rapid deployment of tissue anchors |
US20050251159A1 (en) | 2004-05-07 | 2005-11-10 | Usgi Medical Inc. | Methods and apparatus for grasping and cinching tissue anchors |
US8057511B2 (en) | 2004-05-07 | 2011-11-15 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
US8206417B2 (en) | 2004-06-09 | 2012-06-26 | Usgi Medical Inc. | Apparatus and methods for optimizing anchoring force |
JP4669315B2 (en) * | 2005-04-21 | 2011-04-13 | 日本シャーウッド株式会社 | Organ fixture and organ fixture set |
JP2006102255A (en) * | 2004-10-06 | 2006-04-20 | Nippon Sherwood Medical Industries Ltd | Connecting structure of infusion line and connector with the connecting structure |
US7468074B2 (en) | 2004-10-29 | 2008-12-23 | Arthrex, Inc. | Ligament fixation using graft harness |
US8128658B2 (en) | 2004-11-05 | 2012-03-06 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to bone |
US7857830B2 (en) | 2006-02-03 | 2010-12-28 | Biomet Sports Medicine, Llc | Soft tissue repair and conduit device |
US20060190042A1 (en) | 2004-11-05 | 2006-08-24 | Arthrotek, Inc. | Tissue repair assembly |
US8088130B2 (en) | 2006-02-03 | 2012-01-03 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US7601165B2 (en) | 2006-09-29 | 2009-10-13 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable suture loop |
US8137382B2 (en) | 2004-11-05 | 2012-03-20 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US8118836B2 (en) | 2004-11-05 | 2012-02-21 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US7144415B2 (en) | 2004-11-16 | 2006-12-05 | The Anspach Effort, Inc. | Anchor/suture used for medical procedures |
US7789890B2 (en) | 2005-03-30 | 2010-09-07 | Ethicon Endo-Surgery, Inc. | Harness and balloon catheter assembly and method for use in anastomosis procedures |
ATE492218T1 (en) | 2005-03-30 | 2011-01-15 | Arthrex Inc | HIGH-STRENGTH CHAIN-LIKE SEAM WITH LOOP FOR KNOTLESS FASTENING |
JP5204647B2 (en) | 2005-05-04 | 2013-06-05 | アール アンド ディー コンセプツ アーゲー | Connecting member |
US9149266B2 (en) | 2005-05-20 | 2015-10-06 | Neotract, Inc. | Deforming anchor device |
US8157815B2 (en) | 2005-05-20 | 2012-04-17 | Neotract, Inc. | Integrated handle assembly for anchor delivery system |
US8298291B2 (en) * | 2005-05-26 | 2012-10-30 | Usgi Medical, Inc. | Methods and apparatus for securing and deploying tissue anchors |
US9585651B2 (en) * | 2005-05-26 | 2017-03-07 | Usgi Medical, Inc. | Methods and apparatus for securing and deploying tissue anchors |
US20070083236A1 (en) | 2005-06-24 | 2007-04-12 | Smith & Nephew, Inc. | Methods and devices for tissue repair |
US20060293709A1 (en) * | 2005-06-24 | 2006-12-28 | Bojarski Raymond A | Tissue repair device |
ES2304652T3 (en) | 2005-07-08 | 2008-10-16 | Biedermann Motech Gmbh | ANCHORING ELEMENT FOR BONES. |
IL170698A (en) | 2005-09-06 | 2011-11-30 | Allium Ltd | System for delivering a medical device to a body location |
US8758375B2 (en) | 2005-09-28 | 2014-06-24 | Olympus Medical Systems Corp | Method for suturing perforation |
DE602006007429D1 (en) | 2005-12-26 | 2009-08-06 | Bernard Bouffier | Surgical prosthesis for supporting an organ |
US8133279B2 (en) | 2006-04-27 | 2012-03-13 | Warsaw Orthopedic, Inc. | Methods for treating an annulus defect of an intervertebral disc |
US7850710B2 (en) | 2006-05-23 | 2010-12-14 | St. Jude Medical Puerto Rico Llc | Puncture closure apparatuses, sealing plugs, and related methods |
WO2007146873A1 (en) | 2006-06-09 | 2007-12-21 | Cordis Corporation | Single disc occlusionary patent foramen ovale closure device |
AU2007257706B2 (en) | 2006-06-09 | 2012-08-30 | Cardinal Health 529, Llc | Single disc intraluminal patent foramen ovale closure device |
US20080033487A1 (en) | 2006-08-07 | 2008-02-07 | Bioduct, Llc | Medical device for repair of tissue and method for implantation and fixation |
US7998108B2 (en) | 2006-09-12 | 2011-08-16 | Psivida Us, Inc. | Injector apparatus and method of use |
US20080147086A1 (en) | 2006-10-05 | 2008-06-19 | Marcus Pfister | Integrating 3D images into interventional procedures |
US8906044B2 (en) | 2006-10-20 | 2014-12-09 | St. Jude Medical, Cardiology Division, Inc. | Knot pusher device |
US7850714B2 (en) | 2006-12-15 | 2010-12-14 | Kimberly-Clark Worldwide, Inc. | Segmented tissue-to-tissue anchoring device and method of using the same |
US8197491B2 (en) | 2006-12-19 | 2012-06-12 | Synthes Usa, Llc | Injectable fastener system and method |
US7901431B2 (en) | 2007-01-17 | 2011-03-08 | Arthrex, Inc. | Lisfranc repair using suture-button construct |
WO2008010738A2 (en) | 2007-01-24 | 2008-01-24 | Uros Babic | Patent foramen ovale occluder with suture based anchor |
US7780702B2 (en) | 2007-02-27 | 2010-08-24 | Olympus Medical Systems Corp. | Suture tool |
US8911461B2 (en) | 2007-03-13 | 2014-12-16 | Mitralign, Inc. | Suture cutter and method of cutting suture |
US20080228265A1 (en) | 2007-03-13 | 2008-09-18 | Mitralign, Inc. | Tissue anchors, systems and methods, and devices |
US9314234B2 (en) * | 2007-07-03 | 2016-04-19 | Ceterix Orthopaedics, Inc. | Pre-tied surgical knots for use with suture passers |
EP2200540A4 (en) | 2007-08-02 | 2011-03-02 | Proactive Orthopedic Llc | Fixation and alignment device and method used in orthopaedic surgery |
US20110202074A1 (en) | 2008-04-09 | 2011-08-18 | Talmo Paul A | Devices and methods for deploying medical sutures |
US8317806B2 (en) | 2008-05-30 | 2012-11-27 | Ethicon Endo-Surgery, Inc. | Endoscopic suturing tension controlling and indication devices |
CN102088915A (en) | 2008-06-06 | 2011-06-08 | 斯恩蒂斯有限公司 | Suture based tissue repair |
CN100556375C (en) * | 2008-07-03 | 2009-11-04 | 华斌 | Blind type suture knotter |
US9050077B2 (en) | 2008-09-18 | 2015-06-09 | Smith & Nephew, Inc. | Suture anchor inserter |
US8333788B2 (en) * | 2008-10-09 | 2012-12-18 | Covidien Lp | Knotted suture end effector |
US8323316B2 (en) * | 2008-10-09 | 2012-12-04 | Covidien Lp | Knotted suture end effector |
JP2010165577A (en) | 2009-01-16 | 2010-07-29 | Nok Corp | Seal structure of fuel battery cell |
WO2010088561A2 (en) | 2009-01-30 | 2010-08-05 | Kfx Medical Corporation | System and method for attaching soft tissue to bone |
EP2238944B1 (en) | 2009-03-31 | 2015-10-21 | Arthrex Inc | Adjustable suture button construct for tissue reconstruction |
CN102365828B (en) | 2009-03-31 | 2014-04-16 | 株式会社村田制作所 | Signal transmission communication unit and coupler |
EP2429411B1 (en) | 2009-05-12 | 2017-03-08 | The Foundry, LLC | Devices to treat diseased or injured musculoskeletal tissue |
US20110106151A1 (en) * | 2009-07-22 | 2011-05-05 | Mcdevitt Dennis | Square lock suture knot |
US8828053B2 (en) | 2009-07-24 | 2014-09-09 | Depuy Mitek, Llc | Methods and devices for repairing and anchoring damaged tissue |
US8236011B2 (en) | 2009-10-06 | 2012-08-07 | Ethicon Endo-Surgery, Inc. | Method for deploying fasteners for use in a gastric volume reduction procedure |
US8652153B2 (en) | 2010-01-11 | 2014-02-18 | Anulex Technologies, Inc. | Intervertebral disc annulus repair system and bone anchor delivery tool |
CN102933158B (en) | 2010-04-27 | 2015-11-25 | 斯恩蒂斯有限公司 | Comprise the anchoring assembly of expandable anchor |
EP2588007B1 (en) | 2010-06-29 | 2015-08-26 | Synthes GmbH | Insertion instrument for anchor assembly |
US8920436B2 (en) | 2011-01-13 | 2014-12-30 | Usgi Medical, Inc. | Endoscopic tissue anchor deployment |
AU2011354722B2 (en) | 2011-01-14 | 2016-06-02 | Synthes Gmbh | Insertion instrument for anchor assembley |
US8795334B2 (en) * | 2011-01-28 | 2014-08-05 | Smith & Nephew, Inc. | Tissue repair |
EP2675363B1 (en) * | 2011-02-16 | 2018-05-23 | Linvatec Corporation | Apparatus for securing an object to bone |
US9421008B2 (en) | 2011-09-23 | 2016-08-23 | Arthrex, Inc. | Soft suture-based anchors |
-
2009
- 2009-07-24 US US12/509,112 patent/US8828053B2/en active Active
-
2010
- 2010-07-12 AU AU2010202936A patent/AU2010202936B2/en active Active
- 2010-07-22 CA CA2710885A patent/CA2710885A1/en not_active Abandoned
- 2010-07-23 CN CN201010236588.2A patent/CN101961257B/en not_active Expired - Fee Related
- 2010-07-23 JP JP2010165574A patent/JP5661361B2/en active Active
- 2010-07-26 EP EP10251328.0A patent/EP2277457B1/en active Active
-
2014
- 2014-08-08 US US14/455,331 patent/US10004495B2/en active Active
-
2018
- 2018-05-29 US US15/991,189 patent/US11141149B2/en active Active
-
2021
- 2021-09-10 US US17/471,283 patent/US20210401432A1/en active Pending
Patent Citations (105)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US113548A (en) * | 1871-04-11 | Improvement in folding table-tops | ||
US148913A (en) * | 1874-03-24 | Improvement in governors | ||
US149490A (en) * | 1874-04-07 | Improvement in permutation-locks | ||
US154969A (en) * | 1874-09-15 | Improvement in spinning-wheels | ||
US161085A (en) * | 1875-03-23 | Improvement in steam-radiators | ||
US263343A (en) * | 1882-08-29 | Tread for horse powers | ||
US386728A (en) * | 1888-07-24 | db long | ||
US453120A (en) * | 1891-05-26 | Furnace for roasting ores | ||
US3580256A (en) * | 1969-06-30 | 1971-05-25 | Jack E Wilkinson | Pre-tied suture and method of suturing |
US4006747A (en) * | 1975-04-23 | 1977-02-08 | Ethicon, Inc. | Surgical method |
US5417691A (en) * | 1982-05-20 | 1995-05-23 | Hayhurst; John O. | Apparatus and method for manipulating and anchoring tissue |
US5601557A (en) * | 1982-05-20 | 1997-02-11 | Hayhurst; John O. | Anchoring and manipulating tissue |
US4741330A (en) * | 1983-05-19 | 1988-05-03 | Hayhurst John O | Method and apparatus for anchoring and manipulating cartilage |
US4669473A (en) * | 1985-09-06 | 1987-06-02 | Acufex Microsurgical, Inc. | Surgical fastener |
US4994028A (en) * | 1987-03-18 | 1991-02-19 | Endocon, Inc. | Injector for inplanting multiple pellet medicaments |
US5041129A (en) * | 1990-07-02 | 1991-08-20 | Acufex Microsurgical, Inc. | Slotted suture anchor and method of anchoring a suture |
US5643319A (en) * | 1991-05-13 | 1997-07-01 | United States Surgical Corporation | Device for applying a meniscal staple |
US5156616A (en) * | 1992-02-10 | 1992-10-20 | Meadows Bruce F | Apparatus and method for suture attachment |
US5540703A (en) * | 1993-01-06 | 1996-07-30 | Smith & Nephew Richards Inc. | Knotted cable attachment apparatus formed of braided polymeric fibers |
US5628756A (en) * | 1993-01-06 | 1997-05-13 | Smith & Nephew Richards Inc. | Knotted cable attachment apparatus formed of braided polymeric fibers |
US5562684A (en) * | 1994-10-11 | 1996-10-08 | Ethicon, Inc. | Surgical knot pusher device and improved method of forming knots |
US5824093A (en) * | 1994-10-17 | 1998-10-20 | Raymedica, Inc. | Prosthetic spinal disc nucleus |
US5562736A (en) * | 1994-10-17 | 1996-10-08 | Raymedica, Inc. | Method for surgical implantation of a prosthetic spinal disc nucleus |
US5626614A (en) * | 1995-12-22 | 1997-05-06 | Applied Medical Resources Corporation | T-anchor suturing device and method for using same |
US5957953A (en) * | 1996-02-16 | 1999-09-28 | Smith & Nephew, Inc. | Expandable suture anchor |
US5970697A (en) * | 1997-04-24 | 1999-10-26 | Jacobs; William J. B. | Line with double spliced loops |
US5944739A (en) * | 1998-03-12 | 1999-08-31 | Surgical Dynamics, Inc. | Suture anchor installation system |
US6224630B1 (en) * | 1998-05-29 | 2001-05-01 | Advanced Bio Surfaces, Inc. | Implantable tissue repair device |
US5951590A (en) * | 1998-06-09 | 1999-09-14 | Goldfarb; Michael A. | Soft tissue suture anchor |
US6758855B2 (en) * | 1998-08-19 | 2004-07-06 | Artemis Medical, Inc. | Target tissue localization device |
US6110183A (en) * | 1998-12-22 | 2000-08-29 | Cook Incorporated | Suture anchor device |
US6306159B1 (en) * | 1998-12-23 | 2001-10-23 | Depuy Orthopaedics, Inc. | Meniscal repair device |
US6432123B2 (en) * | 1998-12-30 | 2002-08-13 | Ethicon, Inc. | Suture locking device |
US6530933B1 (en) * | 1998-12-31 | 2003-03-11 | Teresa T. Yeung | Methods and devices for fastening bulging or herniated intervertebral discs |
US6245107B1 (en) * | 1999-05-28 | 2001-06-12 | Bret A. Ferree | Methods and apparatus for treating disc herniation |
US20040097980A1 (en) * | 1999-05-28 | 2004-05-20 | Ferree Bret A. | Methods and apparatus for treating disc herniation and preventing the extrusion of interbody bone graft |
US20020115999A1 (en) * | 1999-07-23 | 2002-08-22 | Mcdevitt Dennis | System and method for attaching soft tissue to bone |
US6719797B1 (en) * | 1999-08-13 | 2004-04-13 | Bret A. Ferree | Nucleus augmentation with in situ formed hydrogels |
US6508839B1 (en) * | 1999-08-18 | 2003-01-21 | Intrinsic Orthopedics, Inc. | Devices and methods of vertebral disc augmentation |
US20020065536A1 (en) * | 1999-08-30 | 2002-05-30 | Applied Medical Resources Corporation | Surgical clip |
US20070156245A1 (en) * | 1999-10-20 | 2007-07-05 | Cauthen Joseph C Iii | Method and apparatus for the treatment of the intervertebral disc annulus |
US20090030522A1 (en) * | 1999-10-20 | 2009-01-29 | Anulex Technologies, Inc. | Method and Apparatus for the Treatment of the Intervertebral Disc Annulus |
US7670379B2 (en) * | 1999-10-20 | 2010-03-02 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method |
US7670380B2 (en) * | 1999-10-20 | 2010-03-02 | Anulex Technologies, Inc. | Intervertebral disc annulus stent |
US20090157184A1 (en) * | 1999-10-20 | 2009-06-18 | Anulex Technologies, Inc. | Method and Apparatus for the Treatment of the Intervertebral Disc Annulus |
US20090036937A1 (en) * | 1999-10-20 | 2009-02-05 | Anulex Technologies, Inc | Method and Apparatus for the Treatement of the Intervertebral Disc Annulus |
US20090036989A1 (en) * | 1999-10-20 | 2009-02-05 | Anulex Technologies, Inc. | Method and Apparatus for the Treatment of the Intervertebral Disc Annulus |
US20090036990A1 (en) * | 1999-10-20 | 2009-02-05 | Anulex Technologies, Inc. | Method and Apparatus for the Treatment of the Intervertebral Disc Annulus |
US7749273B2 (en) * | 1999-10-20 | 2010-07-06 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US7004970B2 (en) * | 1999-10-20 | 2006-02-28 | Anulex Technologies, Inc. | Methods and devices for spinal disc annulus reconstruction and repair |
US7776096B2 (en) * | 1999-10-20 | 2010-08-17 | Anulex Technologies, Inc. | Intervertebral disc annulus stent |
US20070100348A1 (en) * | 1999-10-20 | 2007-05-03 | Cauthen Joseph C Iii | Apparatus and methods for the treatment of the intervertebral disc |
US7909879B2 (en) * | 1999-10-20 | 2011-03-22 | Anulex Technologies, Inc. | Intervertebral disc annulus stent |
US7922768B2 (en) * | 1999-10-20 | 2011-04-12 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and deformable spinal disc annulus stent |
US7651509B2 (en) * | 1999-12-02 | 2010-01-26 | Smith & Nephew, Inc. | Methods and devices for tissue repair |
US6296659B1 (en) * | 2000-02-29 | 2001-10-02 | Opus Medical, Inc. | Single-tailed suturing method and apparatus |
US7753941B2 (en) * | 2000-04-04 | 2010-07-13 | Anulex Technologies, Inc. | Devices and methods for annular repair of intervertebral discs |
US7905923B2 (en) * | 2000-04-04 | 2011-03-15 | Anulex Technologies, Inc. | Devices and methods for annular repair of intervertebral discs |
US6689125B1 (en) * | 2000-04-04 | 2004-02-10 | Spinalabs, Llc | Devices and methods for the treatment of spinal disorders |
US6579291B1 (en) * | 2000-10-10 | 2003-06-17 | Spinalabs, Llc | Devices and methods for the treatment of spinal disorders |
US8083768B2 (en) * | 2000-12-14 | 2011-12-27 | Ensure Medical, Inc. | Vascular plug having composite construction |
US7048754B2 (en) * | 2002-03-01 | 2006-05-23 | Evalve, Inc. | Suture fasteners and methods of use |
US20030167071A1 (en) * | 2002-03-01 | 2003-09-04 | Evalve, Inc. | Suture fasteners and methods of use |
US7335221B2 (en) * | 2002-04-12 | 2008-02-26 | Ethicon, Inc. | Suture anchoring and tensioning device and method for using same |
US6972027B2 (en) * | 2002-06-26 | 2005-12-06 | Stryker Endoscopy | Soft tissue repair system |
US7033393B2 (en) * | 2002-06-27 | 2006-04-25 | Raymedica, Inc. | Self-transitioning spinal disc anulus occulsion device and method of use |
US20040153074A1 (en) * | 2003-02-05 | 2004-08-05 | Bojarski Raymond A. | Tissue anchor and insertion tool |
US20040162618A1 (en) * | 2003-02-14 | 2004-08-19 | Centerpulse Spine-Tech, Inc. | Expandable intervertebral implant cage |
US20050080422A1 (en) * | 2003-10-14 | 2005-04-14 | Centerpulse Spine-Tech, Inc. | Instruments for use with implants, and methods |
US20080188893A1 (en) * | 2004-02-24 | 2008-08-07 | Depuy Mitek, Inc. | Methods and devices for repairing tissue |
US7390332B2 (en) * | 2004-02-24 | 2008-06-24 | Depuy Mitek, Inc. | Methods and devices for repairing tissue |
US20080086155A1 (en) * | 2004-05-07 | 2008-04-10 | Usgi Medical, Inc. | Apparatus and methods for manipulating and securing tissue |
US7621925B2 (en) * | 2004-05-07 | 2009-11-24 | Usgi Medical, Inc. | Needle assembly for tissue manipulation |
US7347863B2 (en) * | 2004-05-07 | 2008-03-25 | Usgi Medical, Inc. | Apparatus and methods for manipulating and securing tissue |
US20050277966A1 (en) * | 2004-06-09 | 2005-12-15 | Usgi Medical Inc. | Compressible tissue anchor assemblies |
US7736379B2 (en) * | 2004-06-09 | 2010-06-15 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
US7678135B2 (en) * | 2004-06-09 | 2010-03-16 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
US20080177304A1 (en) * | 2004-09-29 | 2008-07-24 | Usgi Medical, Inc. | Apparatus for grasping and cinching tissue anchors |
US20060178680A1 (en) * | 2005-02-07 | 2006-08-10 | Regen Biologics, Inc. | System and method for all-inside suture fixation for implant attachment and soft tissue repair |
US20070027476A1 (en) * | 2005-02-07 | 2007-02-01 | Regen Biologics, Inc. | System and method for all-inside suture fixation for implant attachment and soft tissue repair |
US20060265008A1 (en) * | 2005-05-18 | 2006-11-23 | Terumo Kabushiki Kaisha | Tissue closing device |
US20070010857A1 (en) * | 2005-07-05 | 2007-01-11 | Mitralign, Inc. | Tissue anchor, anchoring system and methods of using the same |
US20070129804A1 (en) * | 2005-12-07 | 2007-06-07 | Zimmer Spine, Inc. | Transforaminal lumbar interbody fusion spacers |
US20080140093A1 (en) * | 2006-02-03 | 2008-06-12 | Stone Kevin T | Soft tissue repair device and associated methods |
US20120046693A1 (en) * | 2006-02-03 | 2012-02-23 | Biomet Sports Medicine, Llc | Method and Apparatus for Forming a Self-Locking Adjustable Loop |
US7749250B2 (en) * | 2006-02-03 | 2010-07-06 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US7905904B2 (en) * | 2006-02-03 | 2011-03-15 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US20120053630A1 (en) * | 2006-02-03 | 2012-03-01 | Biomet Sports Medicine, Llc | Method and Apparatus for Forming a Self-Locking Adjustable Loop |
US20090306711A1 (en) * | 2006-02-03 | 2009-12-10 | Biomet Sports Medicine, Llc | Method for Tissue Fixation |
US20080009888A1 (en) * | 2006-07-07 | 2008-01-10 | Usgi Medical, Inc. | Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use |
US20090082805A1 (en) * | 2006-09-29 | 2009-03-26 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US7959650B2 (en) * | 2006-09-29 | 2011-06-14 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US20080195145A1 (en) * | 2007-02-13 | 2008-08-14 | Bonutti Peter M | Tissue fixation system and method |
US7731732B2 (en) * | 2007-08-31 | 2010-06-08 | Ken Christopher G M | Closure medical device |
US20090069823A1 (en) * | 2007-09-12 | 2009-03-12 | Foerster Seth A | Implant and delivery system for soft tissue repair |
US20090228042A1 (en) * | 2008-03-04 | 2009-09-10 | Koogle Jr David C | Method and system for meniscal repair using suture implant cinch construct |
US20100049212A1 (en) * | 2008-04-02 | 2010-02-25 | David Caborn | Method and apparatus for meniscal repair |
US20100094425A1 (en) * | 2008-10-14 | 2010-04-15 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US20120035654A1 (en) * | 2009-03-14 | 2012-02-09 | Vasostitch, Inc. | Methods and systems for advancing and anchoring suture in tissue |
US20110022084A1 (en) * | 2009-07-24 | 2011-01-27 | Mehmet Ziya Sengun | Methods and devices for repairing and anchoring damaged tissue |
US20120004669A1 (en) * | 2010-04-27 | 2012-01-05 | Tom Overes | Insertion instrument for anchor assembly |
US20120109156A1 (en) * | 2010-04-27 | 2012-05-03 | Tom Overes | Methods for approximating a tissue defect using an anchor assembly |
US20120143215A1 (en) * | 2010-04-27 | 2012-06-07 | Ernie Corrao | Insertion instrument for anchor assembly |
US20120150223A1 (en) * | 2010-04-27 | 2012-06-14 | Jamie Manos | Stitch lock for attaching two or more structures |
US20120130422A1 (en) * | 2010-11-24 | 2012-05-24 | Arthrocare Corporation | Novel suture |
Cited By (361)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10265064B2 (en) | 2004-11-05 | 2019-04-23 | Biomet Sports Medicine, Llc | Soft tissue repair device and method |
US9801708B2 (en) | 2004-11-05 | 2017-10-31 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8840645B2 (en) | 2004-11-05 | 2014-09-23 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9572655B2 (en) | 2004-11-05 | 2017-02-21 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US11109857B2 (en) | 2004-11-05 | 2021-09-07 | Biomet Sports Medicine, Llc | Soft tissue repair device and method |
US9504460B2 (en) | 2004-11-05 | 2016-11-29 | Biomet Sports Medicine, LLC. | Soft tissue repair device and method |
US8998949B2 (en) | 2004-11-09 | 2015-04-07 | Biomet Sports Medicine, Llc | Soft tissue conduit device |
US20060282085A1 (en) * | 2004-11-09 | 2006-12-14 | Arthrotek, Inc. | Soft tissue conduit device |
US9603591B2 (en) | 2006-02-03 | 2017-03-28 | Biomet Sports Medicine, Llc | Flexible anchors for tissue fixation |
US10398428B2 (en) | 2006-02-03 | 2019-09-03 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US10092288B2 (en) | 2006-02-03 | 2018-10-09 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10098629B2 (en) | 2006-02-03 | 2018-10-16 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10154837B2 (en) | 2006-02-03 | 2018-12-18 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US12064101B2 (en) | 2006-02-03 | 2024-08-20 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US10251637B2 (en) | 2006-02-03 | 2019-04-09 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US10321906B2 (en) | 2006-02-03 | 2019-06-18 | Biomet Sports Medicine, Llc | Method for tissue fixation |
US9801620B2 (en) | 2006-02-03 | 2017-10-31 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to bone |
US11998185B2 (en) | 2006-02-03 | 2024-06-04 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US11896210B2 (en) | 2006-02-03 | 2024-02-13 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US11819205B2 (en) | 2006-02-03 | 2023-11-21 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US11786236B2 (en) | 2006-02-03 | 2023-10-17 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US10687803B2 (en) | 2006-02-03 | 2020-06-23 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8771316B2 (en) | 2006-02-03 | 2014-07-08 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US11730464B2 (en) | 2006-02-03 | 2023-08-22 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US11723648B2 (en) | 2006-02-03 | 2023-08-15 | Biomet Sports Medicine, Llc | Method and apparatus for soft tissue fixation |
US9763656B2 (en) | 2006-02-03 | 2017-09-19 | Biomet Sports Medicine, Llc | Method and apparatus for soft tissue fixation |
US10441264B2 (en) | 2006-02-03 | 2019-10-15 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US11617572B2 (en) | 2006-02-03 | 2023-04-04 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US10517587B2 (en) | 2006-02-03 | 2019-12-31 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US11589859B2 (en) | 2006-02-03 | 2023-02-28 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to bone |
US10542967B2 (en) | 2006-02-03 | 2020-01-28 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10595851B2 (en) | 2006-02-03 | 2020-03-24 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9642661B2 (en) | 2006-02-03 | 2017-05-09 | Biomet Sports Medicine, Llc | Method and Apparatus for Sternal Closure |
US11471147B2 (en) | 2006-02-03 | 2022-10-18 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10603029B2 (en) | 2006-02-03 | 2020-03-31 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to bone |
US9622736B2 (en) | 2006-02-03 | 2017-04-18 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US10022118B2 (en) | 2006-02-03 | 2018-07-17 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US11446019B2 (en) | 2006-02-03 | 2022-09-20 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10695052B2 (en) | 2006-02-03 | 2020-06-30 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US8968364B2 (en) | 2006-02-03 | 2015-03-03 | Biomet Sports Medicine, Llc | Method and apparatus for fixation of an ACL graft |
US11317907B2 (en) | 2006-02-03 | 2022-05-03 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US20110218625A1 (en) * | 2006-02-03 | 2011-09-08 | Biomet Sports Medicine, Llc | Method and Apparatus for Fixation of an ACL Graft |
US8936621B2 (en) | 2006-02-03 | 2015-01-20 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US9005287B2 (en) | 2006-02-03 | 2015-04-14 | Biomet Sports Medicine, Llc | Method for bone reattachment |
US9561025B2 (en) | 2006-02-03 | 2017-02-07 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US10675073B2 (en) | 2006-02-03 | 2020-06-09 | Biomet Sports Medicine, Llc | Method and apparatus for sternal closure |
US11311287B2 (en) | 2006-02-03 | 2022-04-26 | Biomet Sports Medicine, Llc | Method for tissue fixation |
US9538998B2 (en) | 2006-02-03 | 2017-01-10 | Biomet Sports Medicine, Llc | Method and apparatus for fracture fixation |
US9532777B2 (en) | 2006-02-03 | 2017-01-03 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US11284884B2 (en) | 2006-02-03 | 2022-03-29 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US9510821B2 (en) | 2006-02-03 | 2016-12-06 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US9510819B2 (en) | 2006-02-03 | 2016-12-06 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US9149267B2 (en) | 2006-02-03 | 2015-10-06 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10004588B2 (en) | 2006-02-03 | 2018-06-26 | Biomet Sports Medicine, Llc | Method and apparatus for fixation of an ACL graft |
US9173651B2 (en) | 2006-02-03 | 2015-11-03 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US11259792B2 (en) | 2006-02-03 | 2022-03-01 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US9498204B2 (en) | 2006-02-03 | 2016-11-22 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US9492158B2 (en) | 2006-02-03 | 2016-11-15 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US11116495B2 (en) | 2006-02-03 | 2021-09-14 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US10702259B2 (en) | 2006-02-03 | 2020-07-07 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US9993241B2 (en) | 2006-02-03 | 2018-06-12 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US9468433B2 (en) | 2006-02-03 | 2016-10-18 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US10716557B2 (en) | 2006-02-03 | 2020-07-21 | Biomet Sports Medicine, Llc | Method and apparatus for coupling anatomical features |
US9271713B2 (en) | 2006-02-03 | 2016-03-01 | Biomet Sports Medicine, Llc | Method and apparatus for tensioning a suture |
US11065103B2 (en) | 2006-02-03 | 2021-07-20 | Biomet Sports Medicine, Llc | Method and apparatus for fixation of an ACL graft |
US10729430B2 (en) | 2006-02-03 | 2020-08-04 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10004489B2 (en) | 2006-02-03 | 2018-06-26 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10729421B2 (en) | 2006-02-03 | 2020-08-04 | Biomet Sports Medicine, Llc | Method and apparatus for soft tissue fixation |
US11039826B2 (en) | 2006-02-03 | 2021-06-22 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US9414833B2 (en) | 2006-02-03 | 2016-08-16 | Biomet Sports Medicine, Llc | Soft tissue repair assembly and associated method |
US10987099B2 (en) | 2006-02-03 | 2021-04-27 | Biomet Sports Medicine, Llc | Method for tissue fixation |
US10973507B2 (en) | 2006-02-03 | 2021-04-13 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10932770B2 (en) | 2006-02-03 | 2021-03-02 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US9402621B2 (en) | 2006-02-03 | 2016-08-02 | Biomet Sports Medicine, LLC. | Method for tissue fixation |
US10743925B2 (en) | 2006-09-29 | 2020-08-18 | Biomet Sports Medicine, Llc | Fracture fixation device |
US9078644B2 (en) | 2006-09-29 | 2015-07-14 | Biomet Sports Medicine, Llc | Fracture fixation device |
US9724090B2 (en) | 2006-09-29 | 2017-08-08 | Biomet Manufacturing, Llc | Method and apparatus for attaching soft tissue to bone |
US10004493B2 (en) | 2006-09-29 | 2018-06-26 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US20100211075A1 (en) * | 2006-09-29 | 2010-08-19 | Biomet Sports Medicine, Llc | Fracture Fixation Device |
US9414925B2 (en) | 2006-09-29 | 2016-08-16 | Biomet Manufacturing, Llc | Method of implanting a knee prosthesis assembly with a ligament link |
US10517714B2 (en) | 2006-09-29 | 2019-12-31 | Biomet Sports Medicine, Llc | Ligament system for knee joint |
US11672527B2 (en) | 2006-09-29 | 2023-06-13 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US10835232B2 (en) | 2006-09-29 | 2020-11-17 | Biomet Sports Medicine, Llc | Fracture fixation device |
US9681940B2 (en) | 2006-09-29 | 2017-06-20 | Biomet Sports Medicine, Llc | Ligament system for knee joint |
US9918826B2 (en) | 2006-09-29 | 2018-03-20 | Biomet Sports Medicine, Llc | Scaffold for spring ligament repair |
US10398430B2 (en) | 2006-09-29 | 2019-09-03 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US11096684B2 (en) * | 2006-09-29 | 2021-08-24 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US10610217B2 (en) | 2006-09-29 | 2020-04-07 | Biomet Sports Medicine, Llc | Method and apparatus for forming a self-locking adjustable loop |
US9486211B2 (en) | 2006-09-29 | 2016-11-08 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US9788876B2 (en) | 2006-09-29 | 2017-10-17 | Biomet Sports Medicine, Llc | Fracture fixation device |
US10349931B2 (en) | 2006-09-29 | 2019-07-16 | Biomet Sports Medicine, Llc | Fracture fixation device |
US11376115B2 (en) | 2006-09-29 | 2022-07-05 | Biomet Sports Medicine, Llc | Prosthetic ligament system for knee joint |
US9833230B2 (en) | 2006-09-29 | 2017-12-05 | Biomet Sports Medicine, Llc | Fracture fixation device |
US11259794B2 (en) | 2006-09-29 | 2022-03-01 | Biomet Sports Medicine, Llc | Method for implanting soft tissue |
US9539003B2 (en) | 2006-09-29 | 2017-01-10 | Biomet Sports Medicine, LLC. | Method and apparatus for forming a self-locking adjustable loop |
US10695045B2 (en) | 2006-09-29 | 2020-06-30 | Biomet Sports Medicine, Llc | Method and apparatus for attaching soft tissue to bone |
US11612391B2 (en) | 2007-01-16 | 2023-03-28 | Biomet Sports Medicine, Llc | Soft tissue repair device and associated methods |
US9861351B2 (en) | 2007-04-10 | 2018-01-09 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US9017381B2 (en) | 2007-04-10 | 2015-04-28 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US20080255613A1 (en) * | 2007-04-10 | 2008-10-16 | Biomet Sports Medicine, Inc. | Adjustable knotless loops |
US10729423B2 (en) | 2007-04-10 | 2020-08-04 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US11185320B2 (en) | 2007-04-10 | 2021-11-30 | Biomet Sports Medicine, Llc | Adjustable knotless loops |
US11534159B2 (en) | 2008-08-22 | 2022-12-27 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
US10149767B2 (en) | 2009-05-28 | 2018-12-11 | Biomet Manufacturing, Llc | Method of implanting knee prosthesis assembly with ligament link |
US8900314B2 (en) | 2009-05-28 | 2014-12-02 | Biomet Manufacturing, Llc | Method of implanting a prosthetic knee joint assembly |
US12016548B2 (en) | 2009-07-16 | 2024-06-25 | Howmedica Osteonics Corp. | Suture anchor implantation instrumentation system |
US11304690B2 (en) | 2009-07-16 | 2022-04-19 | Howmedica Osteonics Corp. | Suture anchor implantation instrumentation system |
US8911474B2 (en) | 2009-07-16 | 2014-12-16 | Howmedica Osteonics Corp. | Suture anchor implantation instrumentation system |
US10159478B2 (en) | 2009-07-16 | 2018-12-25 | Howmedica Osteonics Corp. | Suture anchor implantation instrumentation system |
US9545252B2 (en) | 2009-07-16 | 2017-01-17 | Howmedica Osteonics Corp. | Suture anchor implantation instrumentation system |
US11141149B2 (en) | 2009-07-24 | 2021-10-12 | DePuy Synthes Products, Inc. | Methods and devices for repairing and anchoring damaged tissue |
US10433830B2 (en) | 2009-07-24 | 2019-10-08 | DePuy Synthes Products, Inc. | Methods and devices for repairing meniscal tissue |
US8814903B2 (en) | 2009-07-24 | 2014-08-26 | Depuy Mitek, Llc | Methods and devices for repairing meniscal tissue |
US20110022084A1 (en) * | 2009-07-24 | 2011-01-27 | Mehmet Ziya Sengun | Methods and devices for repairing and anchoring damaged tissue |
US8828053B2 (en) | 2009-07-24 | 2014-09-09 | Depuy Mitek, Llc | Methods and devices for repairing and anchoring damaged tissue |
US10004495B2 (en) | 2009-07-24 | 2018-06-26 | Depuy Mitek, Llc | Methods and devices for repairing and anchoring damaged tissue |
US12016545B2 (en) | 2009-07-24 | 2024-06-25 | DePuy Synthes Products, Inc. | Methods and devices for repairing meniscal tissue |
US10231744B2 (en) | 2009-08-20 | 2019-03-19 | Howmedica Osteonics Corp. | Flexible ACL instrumentation, kit and method |
US11364041B2 (en) | 2009-08-20 | 2022-06-21 | Howmedica Osteonics Corp. | Flexible ACL instrumentation, kit and method |
US10595839B2 (en) | 2010-04-27 | 2020-03-24 | DePuy Synthes Products, Inc. | Insertion instrument for anchor assembly |
US20120004669A1 (en) * | 2010-04-27 | 2012-01-05 | Tom Overes | Insertion instrument for anchor assembly |
US9743919B2 (en) * | 2010-04-27 | 2017-08-29 | DePuy Synthes Products, Inc. | Stitch lock for attaching two or more structures |
US9713464B2 (en) | 2010-04-27 | 2017-07-25 | DePuy Synthes Products, Inc. | Anchor assembly including expandable anchor |
US10820894B2 (en) * | 2010-04-27 | 2020-11-03 | DePuy Synthes Products, Inc. | Methods for approximating a tissue defect using an anchor assembly |
US20170143328A1 (en) * | 2010-04-27 | 2017-05-25 | DePuy Synthes Products, Inc. | Methods for approximating a tissue defect using an anchor assembly |
US20110270278A1 (en) * | 2010-04-27 | 2011-11-03 | Tom Overes | Anchor assembly including expandable anchor |
AU2011245417B2 (en) * | 2010-04-27 | 2015-04-09 | Synthes Gmbh | Anchor assembly including expandable anchor |
US9173645B2 (en) * | 2010-04-27 | 2015-11-03 | DePuy Synthes Products, Inc. | Anchor assembly including expandable anchor |
US9724080B2 (en) | 2010-04-27 | 2017-08-08 | DePuy Synthes Products, Inc. | Insertion instrument for anchor assembly |
US11779318B2 (en) | 2010-04-27 | 2023-10-10 | DePuy Synthes Products, Inc. | Insertion instrument for anchor assembly |
US9451938B2 (en) * | 2010-04-27 | 2016-09-27 | DePuy Synthes Products, Inc. | Insertion instrument for anchor assembly |
US9597064B2 (en) | 2010-04-27 | 2017-03-21 | DePuy Synthes Products, Inc. | Methods for approximating a tissue defect using an anchor assembly |
US11116492B2 (en) | 2010-04-27 | 2021-09-14 | DePuy Synthes Products, Inc. | Insertion instrument for anchor assembly |
US9763719B2 (en) | 2010-08-17 | 2017-09-19 | Redyns Medical Llc | Method and apparatus for attaching soft tissue to bone |
US9775605B2 (en) | 2010-08-30 | 2017-10-03 | Depuy Mitek, Llc | Knotless suture anchor with unthreaded nose |
US11497487B2 (en) | 2010-08-30 | 2022-11-15 | DePuy Synthes Products, Inc. | Knotless suture anchor with unthreaded nose |
US11344289B2 (en) | 2010-08-30 | 2022-05-31 | DePuy Synthes Products, Inc. | Knotless suture anchor and driver |
US10595858B2 (en) | 2010-08-30 | 2020-03-24 | DePuy Synthes Products, Inc. | Knotless suture anchor with unthreaded nose |
US8460340B2 (en) | 2010-08-30 | 2013-06-11 | Depuy Mitek, Llc | Knotless suture anchor |
US8469998B2 (en) | 2010-08-30 | 2013-06-25 | Depuy Mitek, Llc | Knotless suture anchor |
US9364211B2 (en) | 2010-08-30 | 2016-06-14 | Depuy Mitek, Llc | Knotless suture anchor |
US10182809B2 (en) | 2010-08-30 | 2019-01-22 | Depuy Mitek, Llc | Knotless suture anchor |
US9265496B2 (en) | 2010-08-30 | 2016-02-23 | Depuy Mitek, Llc | Knotless suture anchor and driver |
US8435264B2 (en) | 2010-08-30 | 2013-05-07 | Depuy Mitek, Llc | Knotless suture anchor and driver |
US10660634B2 (en) | 2010-08-30 | 2020-05-26 | DePuy Synthes Products, Inc. | Knotless suture anchor and driver |
US11464506B2 (en) | 2010-08-30 | 2022-10-11 | DePuy Synthes Products, Inc. | Knotless suture anchor |
US9307977B2 (en) | 2010-11-04 | 2016-04-12 | Conmed Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing suture to bone |
WO2012061586A1 (en) * | 2010-11-04 | 2012-05-10 | Looploc, Inc. | Method and apparatus for securing an object to bone using a suture assembly |
US9307978B2 (en) | 2010-11-04 | 2016-04-12 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US20210121172A1 (en) * | 2010-11-04 | 2021-04-29 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US20190046178A1 (en) * | 2010-11-04 | 2019-02-14 | Conmed Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US10888310B2 (en) * | 2010-11-04 | 2021-01-12 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US9119893B2 (en) | 2010-11-04 | 2015-09-01 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US11039827B2 (en) | 2010-11-23 | 2021-06-22 | Medos International Sàrl | Surgical filament snare assemblies |
US9179908B2 (en) | 2010-11-23 | 2015-11-10 | Medos International Sàrl | Surgical filament snare assemblies |
US8821545B2 (en) | 2010-11-23 | 2014-09-02 | Depuy Mitek, Llc | Surgical filament snare assemblies |
US8821544B2 (en) | 2010-11-23 | 2014-09-02 | Depuy Mitek, Llc | Surgical filament snare assemblies |
US8814905B2 (en) | 2010-11-23 | 2014-08-26 | Depuy Mitek, Llc | Surgical filament snare assemblies |
US10292695B2 (en) | 2010-11-23 | 2019-05-21 | Medos International Sàrl | Surgical filament snare assemblies |
US10912549B2 (en) | 2010-11-23 | 2021-02-09 | Medos International Sàrl | Surgical filament snare assemblies |
US9895145B2 (en) | 2010-11-23 | 2018-02-20 | Medos International Sàrl | Surgical filament snare assemblies |
US9345468B2 (en) | 2010-11-23 | 2016-05-24 | Medos International Sárl | Surgical filament snare assemblies |
US9198653B2 (en) | 2010-11-23 | 2015-12-01 | Medos International Sàrl | Surgical filament snare assemblies |
US9532778B2 (en) | 2010-11-23 | 2017-01-03 | Medos International Sàrl | Surgical filament snare assemblies |
US9095331B2 (en) | 2010-12-23 | 2015-08-04 | Medos International Sàrl | Adjustable anchor systems and methods |
US8821543B2 (en) | 2010-12-23 | 2014-09-02 | Depuy Mitek, Llc | Adjustable anchor systems and methods |
US9833229B2 (en) | 2010-12-23 | 2017-12-05 | Medos International Sàrl | Adjustable anchor systems and methods |
US10835231B2 (en) | 2010-12-23 | 2020-11-17 | Medos International Sàrl | Adjustable anchor systems and methods |
US8974495B2 (en) | 2010-12-23 | 2015-03-10 | Medos International Sàrl | Adjustable anchor systems and methods |
US11857176B2 (en) * | 2011-01-28 | 2024-01-02 | Smith & Nephew, Inc. | Tissue repair |
US20220313242A1 (en) * | 2011-01-28 | 2022-10-06 | Smith & Nephew, Inc. | Tissue repair |
US20140296883A1 (en) * | 2011-01-28 | 2014-10-02 | Smith & Nephew, Inc. | Tissue repair |
US9078651B2 (en) * | 2011-01-28 | 2015-07-14 | Smith & Nephew, Inc. | Tissue repair |
US11413031B2 (en) * | 2011-01-28 | 2022-08-16 | Smith & Nephew, Inc. | Tissue repair |
US8795334B2 (en) * | 2011-01-28 | 2014-08-05 | Smith & Nephew, Inc. | Tissue repair |
US20120197271A1 (en) * | 2011-01-28 | 2012-08-02 | Smith & Nephew, Inc. | Tissue repair |
US20190261975A1 (en) * | 2011-01-28 | 2019-08-29 | Smith & Nephew, Inc. | Tissue repair |
US10588617B2 (en) * | 2011-01-28 | 2020-03-17 | Smith & Nephew, Inc. | Tissue repair |
US10631844B2 (en) | 2011-01-28 | 2020-04-28 | Smith & Nephew, Inc. | Tissue repair |
US9370352B2 (en) | 2011-01-28 | 2016-06-21 | Smith & Nephew, Inc. | Tissue repair |
JP2017060823A (en) * | 2011-01-28 | 2017-03-30 | スミス アンド ネフュー インコーポレーテッドSmith & Nephew,Inc. | Tissue repair |
KR20190125512A (en) * | 2011-02-16 | 2019-11-06 | 린바텍 코포레이션 | Method and apparatus for securing an object to bone |
KR102126423B1 (en) | 2011-02-16 | 2020-06-24 | 린바텍 코포레이션 | Method and apparatus for securing an object to bone |
WO2012125617A1 (en) * | 2011-03-14 | 2012-09-20 | Reznik Alan M | Nonlinear self seating suture anchor for confined spaces |
US20170119369A1 (en) * | 2011-05-06 | 2017-05-04 | Linvatec Corporation | Soft anchor made from suture filament and suture tape |
US10687798B2 (en) * | 2011-05-06 | 2020-06-23 | Linvatec Corporation | Soft anchor made from suture filament and suture tape |
US9216078B2 (en) | 2011-05-17 | 2015-12-22 | Biomet Sports Medicine, Llc | Method and apparatus for tibial fixation of an ACL graft |
US20140114404A1 (en) * | 2011-06-27 | 2014-04-24 | University Of Maryland, Baltimore | Transapical mitral valve repair device |
US10285686B2 (en) | 2011-06-27 | 2019-05-14 | University Of Maryland, Baltimore | Transapical mitral valve repair method |
US8852213B2 (en) * | 2011-06-27 | 2014-10-07 | University Of Maryland, Baltimore | Transapical mitral valve repair device |
US11413033B2 (en) | 2011-06-27 | 2022-08-16 | University Of Maryland, Baltimore | Heart valve repair using suture knots |
WO2013016552A1 (en) * | 2011-07-26 | 2013-01-31 | Linvatec Corporation | Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone |
US20170224326A1 (en) * | 2011-09-23 | 2017-08-10 | Artrex, Inc. | Soft suture-based anchors |
US11116491B2 (en) * | 2011-09-23 | 2021-09-14 | Arthrex, Inc. | Soft suture-based anchors |
US11690610B2 (en) | 2011-09-23 | 2023-07-04 | Arthrex, Inc. | Soft suture-based anchors |
US11642119B2 (en) | 2011-09-23 | 2023-05-09 | Arthrex, Inc. | Soft suture-based anchors |
US10595845B2 (en) * | 2011-09-23 | 2020-03-24 | Arthrex, Inc. | Soft suture-based anchors |
US9421008B2 (en) * | 2011-09-23 | 2016-08-23 | Arthrex, Inc. | Soft suture-based anchors |
US11464505B2 (en) | 2011-09-23 | 2022-10-11 | Arthrex, Inc. | Soft suture-based anchors |
US9445827B2 (en) | 2011-10-25 | 2016-09-20 | Biomet Sports Medicine, Llc | Method and apparatus for intraosseous membrane reconstruction |
US10265159B2 (en) | 2011-11-03 | 2019-04-23 | Biomet Sports Medicine, Llc | Method and apparatus for stitching tendons |
US11241305B2 (en) | 2011-11-03 | 2022-02-08 | Biomet Sports Medicine, Llc | Method and apparatus for stitching tendons |
US9357991B2 (en) | 2011-11-03 | 2016-06-07 | Biomet Sports Medicine, Llc | Method and apparatus for stitching tendons |
US9314241B2 (en) | 2011-11-10 | 2016-04-19 | Biomet Sports Medicine, Llc | Apparatus for coupling soft tissue to a bone |
US9357992B2 (en) | 2011-11-10 | 2016-06-07 | Biomet Sports Medicine, Llc | Method for coupling soft tissue to a bone |
US11534157B2 (en) | 2011-11-10 | 2022-12-27 | Biomet Sports Medicine, Llc | Method for coupling soft tissue to a bone |
US9370350B2 (en) | 2011-11-10 | 2016-06-21 | Biomet Sports Medicine, Llc | Apparatus for coupling soft tissue to a bone |
US9381013B2 (en) | 2011-11-10 | 2016-07-05 | Biomet Sports Medicine, Llc | Method for coupling soft tissue to a bone |
US10363028B2 (en) | 2011-11-10 | 2019-07-30 | Biomet Sports Medicine, Llc | Method for coupling soft tissue to a bone |
US10368856B2 (en) | 2011-11-10 | 2019-08-06 | Biomet Sports Medicine, Llc | Apparatus for coupling soft tissue to a bone |
US9962149B2 (en) | 2011-11-14 | 2018-05-08 | Arthrocare Corporation | Tissue repair assembly |
US20210228200A1 (en) * | 2011-11-14 | 2021-07-29 | Arthrocare Corporation | Tissue repair assembly |
US20200029954A1 (en) * | 2011-11-23 | 2020-01-30 | Howmedica Osteonics Corp. | Filamentary Fixation Device |
US11844508B2 (en) * | 2011-11-23 | 2023-12-19 | Howmedica Osteonics Corp. | Filamentary fixation device |
US9445803B2 (en) | 2011-11-23 | 2016-09-20 | Howmedica Osteonics Corp. | Filamentary suture anchor |
US10448944B2 (en) | 2011-11-23 | 2019-10-22 | Howmedica Osteonics Corp. | Filamentary fixation device |
US8926662B2 (en) | 2012-02-01 | 2015-01-06 | Smith & Nephew, Inc. | Tissue graft anchoring |
US9820731B2 (en) | 2012-03-09 | 2017-11-21 | Smith & Nephew, Inc. | Suture-based knotless repair |
US9084597B2 (en) | 2012-03-09 | 2015-07-21 | Smith & Nephew, Inc. | Suture-based knotless repair |
US8790370B2 (en) | 2012-03-30 | 2014-07-29 | Depuy Mitek, Llc | Surgical filament assemblies |
US11771414B2 (en) | 2012-03-30 | 2023-10-03 | Medos International Sarl | Surgical filament assemblies |
US9872678B2 (en) | 2012-03-30 | 2018-01-23 | Medos International Sarl | Surgical filament assemblies |
US10751041B2 (en) | 2012-03-30 | 2020-08-25 | Medos International Sarl | Surgical filament assemblies |
US11076865B2 (en) | 2012-04-06 | 2021-08-03 | Howmedica Osteonics Corp. | Knotless filament anchor for soft tissue repair |
US9808242B2 (en) | 2012-04-06 | 2017-11-07 | Howmedica Osteonics Corp. | Knotless filament anchor for soft tissue repair |
US11076844B2 (en) * | 2012-05-03 | 2021-08-03 | Riverpoint Medical, Llc | Soft suture anchor |
US10271833B2 (en) | 2012-05-07 | 2019-04-30 | Medos International Sàrl | Systems, devices, and methods for securing tissue using snare assemblies and soft anchors |
US11564676B2 (en) | 2012-05-07 | 2023-01-31 | Medos International Sarl | Systems, devices, and methods for securing tissue |
US11272915B2 (en) | 2012-05-07 | 2022-03-15 | Medos International Sarl | Systems, devices, and methods for securing tissue using snare assemblies and soft anchors |
US9060763B2 (en) | 2012-05-07 | 2015-06-23 | Medos International Sàrl | Systems, devices, and methods for securing tissue |
US9060764B2 (en) | 2012-05-07 | 2015-06-23 | Medos International Sàrl | Systems, devices, and methods for securing tissue |
US9034013B2 (en) | 2012-05-07 | 2015-05-19 | Medos International Sàrl | Systems, devices, and methods for securing tissue using a suture having one or more protrusions |
US9795373B2 (en) | 2012-05-07 | 2017-10-24 | Medos International Sàrl | Systems, devices, and methods for securing tissue using a suture having one or more protrusions |
EP2662030A1 (en) | 2012-05-07 | 2013-11-13 | DePuy Mitek, LLC | Systems, devices, and methods for securing tissue using snare assemblies and soft anchors |
US9345567B2 (en) | 2012-05-07 | 2016-05-24 | Medos International Sàrl | Systems, devices, and methods for securing tissue using snare assemblies and soft anchors |
US9757116B2 (en) | 2012-05-07 | 2017-09-12 | Medos International Sárl | Systems, devices, and methods for securing tissue |
US10524777B2 (en) | 2012-05-07 | 2020-01-07 | Medos International Sàrl | Systems, devices, and methods for securing tissue |
US8894684B2 (en) | 2012-05-07 | 2014-11-25 | Medos International Sàrl | Systems, devices, and methods for securing tissue using a suture having one or more protrusions |
US10653410B2 (en) | 2012-08-03 | 2020-05-19 | Howmedica Osteonics Corp. | Soft tissue fixation devices and methods |
US8821494B2 (en) | 2012-08-03 | 2014-09-02 | Howmedica Osteonics Corp. | Surgical instruments and methods of use |
US20140039552A1 (en) * | 2012-08-03 | 2014-02-06 | Howmedica Osteonics Corp. | Soft tissue fixation devices and methods |
US10123792B2 (en) | 2012-08-03 | 2018-11-13 | Howmedica Osteonics Corp. | Soft tissue fixation devices and methods |
US9226744B2 (en) | 2012-08-03 | 2016-01-05 | Howmedica Osteonics Corp. | Surgical instruments and methods of use |
US9480475B2 (en) | 2012-08-15 | 2016-11-01 | DePuy Synthes Products, Inc. | Bone plate suture anchor |
US10182853B2 (en) | 2012-08-15 | 2019-01-22 | DePuy Synthes Products, Inc. | Bone plate suture anchor |
US10695047B2 (en) | 2012-09-20 | 2020-06-30 | Medos International Sarl | Systems, devices, and methods for securing tissue using hard anchors |
US11672523B2 (en) | 2012-09-20 | 2023-06-13 | Medos International Sarl | Systems, devices, and methods for securing tissue using hard anchors |
US9763655B2 (en) | 2012-09-20 | 2017-09-19 | Medos International Sarl | Systems, devices, and methods for securing tissue using hard anchors |
US10010314B2 (en) | 2012-10-18 | 2018-07-03 | Smith & Nephew, Inc. | Flexible anchor delivery system |
US10010316B2 (en) | 2012-10-18 | 2018-07-03 | Smith & Nephew, Inc. | Flexible anchor delivery system |
US8986327B2 (en) | 2012-10-18 | 2015-03-24 | Smith & Nephew, Inc. | Flexible anchor delivery system |
US20140155930A1 (en) * | 2012-12-04 | 2014-06-05 | Cook Medical Technologies Llc | Inferior filter retrieval device |
US9308074B2 (en) * | 2012-12-04 | 2016-04-12 | Cook Medical Technologies Llc | Filter retrieval device |
US10258321B2 (en) | 2012-12-27 | 2019-04-16 | Medos International Sàrl | Surgical constructs and methods for securing tissue |
US11369361B2 (en) | 2012-12-27 | 2022-06-28 | Medos International Sarl | Surgical constructs and methods for securing tissue |
US20140188163A1 (en) * | 2012-12-27 | 2014-07-03 | Depuy Mitek, Llc | Surgical constructs and methods for securing tissue |
US9192373B2 (en) | 2012-12-27 | 2015-11-24 | Medos International Sàrl | Surgical constructs and methods for securing tissue |
US9271716B2 (en) * | 2012-12-27 | 2016-03-01 | Medos International Sàrl | Surgical constructs and methods for securing tissue |
US20150335325A1 (en) * | 2013-01-04 | 2015-11-26 | Anchor Orthopedics Xt Inc. | Devices And Methods for Advancing Knots |
US10849612B2 (en) * | 2013-01-04 | 2020-12-01 | Anchor Orthopedics Xt. Inc. | Devices and methods for advancing knots |
US10285685B2 (en) | 2013-03-04 | 2019-05-14 | Howmedica Osteonics Corp. | Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use |
US9402620B2 (en) | 2013-03-04 | 2016-08-02 | Howmedica Osteonics Corp. | Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use |
US9757119B2 (en) | 2013-03-08 | 2017-09-12 | Biomet Sports Medicine, Llc | Visual aid for identifying suture limbs arthroscopically |
US10856967B2 (en) | 2013-03-11 | 2020-12-08 | Medos International Sàrl | Implant having adjustable filament coils |
US11896475B2 (en) | 2013-03-11 | 2024-02-13 | Medos International Sarl | Implant having adjustable filament coils |
US9788826B2 (en) | 2013-03-11 | 2017-10-17 | Howmedica Osteonics Corp. | Filamentary fixation device and assembly and method of assembly, manufacture and use |
US10052094B2 (en) | 2013-03-11 | 2018-08-21 | Medos International Sàrl | Implant having adjustable filament coils |
US10898178B2 (en) | 2013-03-11 | 2021-01-26 | Medos International Sàrl | Implant having adjustable filament coils |
US9974643B2 (en) | 2013-03-11 | 2018-05-22 | Medos International Sàrl | Implant having adjustable filament coils |
US10182806B2 (en) | 2013-03-12 | 2019-01-22 | Arthrocare Corporation | Tissue repair assembly |
US9463013B2 (en) | 2013-03-13 | 2016-10-11 | Stryker Corporation | Adjustable continuous filament structure and method of manufacture and use |
US9918827B2 (en) | 2013-03-14 | 2018-03-20 | Biomet Sports Medicine, Llc | Scaffold for spring ligament repair |
US10758221B2 (en) | 2013-03-14 | 2020-09-01 | Biomet Sports Medicine, Llc | Scaffold for spring ligament repair |
US9737293B2 (en) | 2013-03-15 | 2017-08-22 | Medos International Sàrl | Surgical constructs with collapsing suture loop and methods for securing tissue |
US11672522B2 (en) | 2013-03-15 | 2023-06-13 | Medos International Sarl | Surgical constructs with collapsing suture loop and methods for securing tissue |
US10631848B2 (en) | 2013-03-15 | 2020-04-28 | Medos International Sàrl | Surgical constructs with collapsing suture loop and methods for securing tissue |
US12048427B2 (en) | 2013-04-22 | 2024-07-30 | Stryker Corporation | Method and apparatus for attaching tissue to bone |
US11331094B2 (en) | 2013-04-22 | 2022-05-17 | Stryker Corporation | Method and apparatus for attaching tissue to bone |
US9757113B2 (en) | 2013-07-31 | 2017-09-12 | Medos International Sàrl | Adjustable graft fixation device |
US10441265B2 (en) | 2013-07-31 | 2019-10-15 | Medos International Sàrl | Adjustable graft fixation device |
US11534288B2 (en) | 2013-12-11 | 2022-12-27 | Medos International Sarl | Implant having filament limbs of an adjustable loop disposed in a shuttle suture |
US10405968B2 (en) | 2013-12-11 | 2019-09-10 | Medos International Sarl | Implant having filament limbs of an adjustable loop disposed in a shuttle suture |
US10610211B2 (en) | 2013-12-12 | 2020-04-07 | Howmedica Osteonics Corp. | Filament engagement system and methods of use |
US10806443B2 (en) | 2013-12-20 | 2020-10-20 | Biomet Sports Medicine, Llc | Knotless soft tissue devices and techniques |
US9962150B2 (en) | 2013-12-20 | 2018-05-08 | Arthrocare Corporation | Knotless all suture tissue repair |
US10136886B2 (en) | 2013-12-20 | 2018-11-27 | Biomet Sports Medicine, Llc | Knotless soft tissue devices and techniques |
US11648004B2 (en) | 2013-12-20 | 2023-05-16 | Biomet Sports Medicine, Llc | Knotless soft tissue devices and techniques |
US11812941B2 (en) * | 2013-12-20 | 2023-11-14 | Arthrocare Corporation | Knotless all suture tissue repair |
US10966705B2 (en) * | 2013-12-20 | 2021-04-06 | Arthrocare Corporation | Knotless all suture tissue repair |
US10639024B2 (en) | 2014-01-03 | 2020-05-05 | University Of Maryland, Baltimore | Method and apparatus for transapical procedures on a mitral valve |
US11678872B2 (en) | 2014-01-03 | 2023-06-20 | University Of Maryland, Baltimore | Method and apparatus for transapical procedures on a mitral valve |
US9681864B1 (en) | 2014-01-03 | 2017-06-20 | Harpoon Medical, Inc. | Method and apparatus for transapical procedures on a mitral valve |
US11096681B2 (en) | 2014-01-03 | 2021-08-24 | Cayenne Medical, Inc. | All-suture suture anchor systems and methods |
US9949733B1 (en) | 2014-01-03 | 2018-04-24 | Cayenne Medical, Inc. | All-suture suture anchor systems and methods |
US9993240B2 (en) | 2014-02-12 | 2018-06-12 | Roy H. Trawick | Meniscal repair device |
US11844510B2 (en) * | 2014-03-05 | 2023-12-19 | Cayenne Medical, Inc. | All-suture suture anchor systems and methods |
US20210186484A1 (en) * | 2014-03-05 | 2021-06-24 | Cayenne Medical, Inc. | All-suture suture anchor systems and methods |
US9615822B2 (en) | 2014-05-30 | 2017-04-11 | Biomet Sports Medicine, Llc | Insertion tools and method for soft anchor |
US9700291B2 (en) | 2014-06-03 | 2017-07-11 | Biomet Sports Medicine, Llc | Capsule retractor |
US20160000427A1 (en) * | 2014-07-04 | 2016-01-07 | Fung-Chao Tu | Suturing and knotting integrated device for laparaoscopic surgery and associated knotting assembly |
US9826974B2 (en) * | 2014-07-04 | 2017-11-28 | Fung-Chao Tu | Suturing and knotting integrated device for laparaoscopic surgery and associated knotting assembly |
US20170202669A1 (en) * | 2014-07-17 | 2017-07-20 | Coremedic Ag | Medical apparatus and method for heart valve repair |
US10405979B2 (en) * | 2014-07-17 | 2019-09-10 | Coremedic Ag | Medical apparatus and method for heart valve repair |
US11219443B2 (en) | 2014-08-22 | 2022-01-11 | Biomet Sports Medicine, Llc | Non-sliding soft anchor |
US10743856B2 (en) | 2014-08-22 | 2020-08-18 | Biomet Sports Medicine, Llc | Non-sliding soft anchor |
US10039543B2 (en) | 2014-08-22 | 2018-08-07 | Biomet Sports Medicine, Llc | Non-sliding soft anchor |
US9986992B2 (en) | 2014-10-28 | 2018-06-05 | Stryker Corporation | Suture anchor and associated methods of use |
US11006945B2 (en) | 2014-10-28 | 2021-05-18 | Stryker Corporation | Suture anchor and associated methods of use |
US10568616B2 (en) | 2014-12-17 | 2020-02-25 | Howmedica Osteonics Corp. | Instruments and methods of soft tissue fixation |
US10499904B2 (en) * | 2015-02-17 | 2019-12-10 | Smith & Nephew, Inc. | Anchor insertion system and method of use thereof |
US9955980B2 (en) | 2015-02-24 | 2018-05-01 | Biomet Sports Medicine, Llc | Anatomic soft tissue repair |
US10912551B2 (en) | 2015-03-31 | 2021-02-09 | Biomet Sports Medicine, Llc | Suture anchor with soft anchor of electrospun fibers |
US20170049432A1 (en) * | 2015-08-20 | 2017-02-23 | Arthrex, Inc. | Tensionable contructs with multi-limb locking mechanism through single splice and methods of tissue repair |
US10265060B2 (en) * | 2015-08-20 | 2019-04-23 | Arthrex, Inc. | Tensionable constructs with multi-limb locking mechanism through single splice and methods of tissue repair |
US20170055975A1 (en) * | 2015-09-02 | 2017-03-02 | Raymond Thal | Adjustable, locking all-suture anchor assembly and method for repair |
US20170071590A1 (en) * | 2015-09-10 | 2017-03-16 | Suture Armor Llc | Suture anchor |
US11672662B2 (en) | 2015-10-02 | 2023-06-13 | Harpoon Medical, Inc. | Short-throw tissue anchor deployment |
US10864080B2 (en) | 2015-10-02 | 2020-12-15 | Harpoon Medical, Inc. | Distal anchor apparatus and methods for mitral valve repair |
US9888998B2 (en) | 2016-01-19 | 2018-02-13 | DePuy Synthes Products, Inc. | Flexible implant with adjustable coils |
US11517421B2 (en) | 2016-01-19 | 2022-12-06 | Medos International Sarl | Flexible implant with adjustable coils |
US10485652B2 (en) | 2016-01-19 | 2019-11-26 | DePuy Synthes Products, Inc. | Flexible implant with adjustable coils |
US11529233B2 (en) | 2016-04-22 | 2022-12-20 | Edwards Lifesciences Corporation | Beating-heart mitral valve chordae replacement |
US10624743B2 (en) | 2016-04-22 | 2020-04-21 | Edwards Lifesciences Corporation | Beating-heart mitral valve chordae replacement |
US11452518B2 (en) | 2016-09-27 | 2022-09-27 | Arthrex, Inc. | Circular suture constructs and methods for use |
US10307154B2 (en) | 2016-09-27 | 2019-06-04 | Arthrex, Inc. | Circular suture constructs and methods for use |
US10682215B2 (en) * | 2016-10-21 | 2020-06-16 | Sofradim Production | Method for forming a mesh having a barbed suture attached thereto and the mesh thus obtained |
US11696819B2 (en) | 2016-10-21 | 2023-07-11 | Sofradim Production | Method for forming a mesh having a barbed suture attached thereto and the mesh thus obtained |
US20180110605A1 (en) * | 2016-10-21 | 2018-04-26 | Sofradim Production | Method for forming a mesh having a barbed suture attached thereto and the mesh thus obtained |
US10660753B2 (en) | 2016-12-30 | 2020-05-26 | Pipeline Medical Techologies, Inc. | Leaflet capture and anchor deployment system |
US11083580B2 (en) | 2016-12-30 | 2021-08-10 | Pipeline Medical Technologies, Inc. | Method of securing a leaflet anchor to a mitral valve leaflet |
US10543090B2 (en) | 2016-12-30 | 2020-01-28 | Pipeline Medical Technologies, Inc. | Neo chordae tendinae deployment system |
US10925731B2 (en) | 2016-12-30 | 2021-02-23 | Pipeline Medical Technologies, Inc. | Method and apparatus for transvascular implantation of neo chordae tendinae |
US10548733B2 (en) | 2016-12-30 | 2020-02-04 | Pipeline Medical Technologies, Inc. | Method of transvascular prosthetic chordae tendinae implantation |
US11690719B2 (en) | 2016-12-30 | 2023-07-04 | Pipeline Medical Technologies, Inc. | Leaflet capture and anchor deployment system |
US11684475B2 (en) | 2016-12-30 | 2023-06-27 | Pipeline Medical Technologies, Inc. | Method and apparatus for transvascular implantation of neo chordae tendinae |
US10667910B2 (en) | 2016-12-30 | 2020-06-02 | Pipeline Medical Technologies, Inc. | Method and apparatus for transvascular implantation of neo chordae tendinae |
US11931262B2 (en) | 2016-12-30 | 2024-03-19 | Pipeline Medical Technologies, Inc. | Method and apparatus for transvascular implantation of neo chordae tendinae |
US11696828B2 (en) | 2016-12-30 | 2023-07-11 | Pipeline Medical Technologies, Inc. | Method and apparatus for mitral valve chord repair |
US11666441B2 (en) | 2016-12-30 | 2023-06-06 | Pipeline Medical Technologies, Inc. | Endovascular suture lock |
US10682230B2 (en) | 2016-12-30 | 2020-06-16 | Pipeline Medical Technologies, Inc. | Apparatus for transvascular implantation of neo chordae tendinae |
US10617523B2 (en) | 2016-12-30 | 2020-04-14 | Pipeline Medical Technologies, Inc. | Tissue anchor with dynamic depth indicator |
US10675150B2 (en) | 2016-12-30 | 2020-06-09 | Pipeline Medical Technologies, Inc. | Method for transvascular implantation of neo chordae tendinae |
US10765515B2 (en) | 2017-04-06 | 2020-09-08 | University Of Maryland, Baltimore | Distal anchor apparatus and methods for mitral valve repair |
US11944540B2 (en) | 2017-04-06 | 2024-04-02 | University Of Maryland, Baltimore | Delivery devices for forming a distal anchor for mitral valve repair |
US11026672B2 (en) | 2017-06-19 | 2021-06-08 | Harpoon Medical, Inc. | Method and apparatus for cardiac procedures |
CN109394284A (en) * | 2017-08-17 | 2019-03-01 | 北京德益达美医疗科技有限公司 | All fronts holdfast |
US11065120B2 (en) | 2017-10-24 | 2021-07-20 | University Of Maryland, Baltimore | Method and apparatus for cardiac procedures |
US11833048B2 (en) | 2017-10-24 | 2023-12-05 | Harpoon Medical, Inc. | Method and apparatus for cardiac procedures |
US20190231338A1 (en) * | 2018-01-31 | 2019-08-01 | Arthrex, Inc. | Active deploying soft anchor |
US10765419B2 (en) * | 2018-01-31 | 2020-09-08 | Arthrex, Inc. | Active deploying soft anchor |
USD976405S1 (en) | 2018-02-22 | 2023-01-24 | Stryker Corporation | Self-punching bone anchor inserter |
USD902405S1 (en) | 2018-02-22 | 2020-11-17 | Stryker Corporation | Self-punching bone anchor inserter |
USD958989S1 (en) | 2018-02-22 | 2022-07-26 | Stryker Corporation | Self-punching bone anchor inserter |
US11517435B2 (en) | 2018-05-04 | 2022-12-06 | Edwards Lifesciences Corporation | Ring-based prosthetic cardiac valve |
US11426157B2 (en) * | 2018-05-30 | 2022-08-30 | Aju Pharm Co., Ltd. | Method of preparing suture anchor using suture and prepared suture anchor |
US11819204B2 (en) | 2020-11-13 | 2023-11-21 | Raymond Thal | Adjustable all-suture anchoring assembly and method |
US12096931B2 (en) | 2021-12-14 | 2024-09-24 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
CN114469217A (en) * | 2022-02-09 | 2022-05-13 | 运医之星(上海)科技有限公司 | Meniscus sewing system and manufacturing method |
US12096928B2 (en) | 2023-01-27 | 2024-09-24 | Biomet Sports Medicine, Llc | Method and apparatus for coupling soft tissue to a bone |
CN116509468A (en) * | 2023-03-13 | 2023-08-01 | 杭州德诺电生理医疗科技有限公司 | Plugging system and knotting method of tightening piece |
US12096929B2 (en) | 2023-06-21 | 2024-09-24 | Smith & Nephew, Inc. | Flexible anchor delivery system |
Also Published As
Publication number | Publication date |
---|---|
US20210401432A1 (en) | 2021-12-30 |
US11141149B2 (en) | 2021-10-12 |
CN101961257B (en) | 2015-10-21 |
EP2277457A1 (en) | 2011-01-26 |
AU2010202936B2 (en) | 2016-02-25 |
CN101961257A (en) | 2011-02-02 |
EP2277457B1 (en) | 2019-01-30 |
AU2010202936A1 (en) | 2011-02-10 |
JP5661361B2 (en) | 2015-01-28 |
US20180271523A1 (en) | 2018-09-27 |
US8828053B2 (en) | 2014-09-09 |
CA2710885A1 (en) | 2011-01-24 |
US10004495B2 (en) | 2018-06-26 |
JP2011025034A (en) | 2011-02-10 |
US20150038992A1 (en) | 2015-02-05 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20210401432A1 (en) | Methods and devices for repairing and anchoring damaged tissue | |
US12016545B2 (en) | Methods and devices for repairing meniscal tissue | |
US20210228200A1 (en) | Tissue repair assembly | |
CN106028959B (en) | Knotless total suture tissue repair | |
AU2015202757B2 (en) | Methods and devices for repairing meniscal tissue |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: DEPUY MITEK, INC., MASSACHUSETTS Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:SENGUN, MEHMET ZIYA;CAPOBIANCO, MARK A.;FIFOLT, DOUGLAS ALLEN;AND OTHERS;SIGNING DATES FROM 20091214 TO 20100113;REEL/FRAME:023980/0839 |
|
AS | Assignment |
Owner name: DEPUY MITEK, LLC, MASSACHUSETTS Free format text: CHANGE OF NAME;ASSIGNOR:DEPUY MITEK, INC.;REEL/FRAME:029001/0313 Effective date: 20120613 |
|
STCF | Information on status: patent grant |
Free format text: PATENTED CASE |
|
MAFP | Maintenance fee payment |
Free format text: PAYMENT OF MAINTENANCE FEE, 4TH YEAR, LARGE ENTITY (ORIGINAL EVENT CODE: M1551) Year of fee payment: 4 |
|
AS | Assignment |
Owner name: DEPUY SYNTHES SALES, INC., MASSACHUSETTS Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:DEPUY MITEK, LLC;REEL/FRAME:048197/0069 Effective date: 20141229 Owner name: DEPUY MITEK HOLDING CORPORATION, MASSACHUSETTS Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:DEPUY MITEK, LLC;REEL/FRAME:048197/0861 Effective date: 20141229 Owner name: DEPUY SYNTHES PRODUCTS, INC., MASSACHUSETTS Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:DEPUY SYNTHES SALES INC.;REEL/FRAME:048197/0142 Effective date: 20141229 Owner name: DEPUY SYNTHES PRODUCTS, LLC, MASSACHUSETTS Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:DEPUY SPINE, LLC;REEL/FRAME:048198/0497 Effective date: 20141229 Owner name: DEPUY SYNTHES PRODUCTS, INC, MASSACHUSETTS Free format text: CHANGE OF NAME;ASSIGNOR:DEPUY SYNTHES PRODUCTS, LLC;REEL/FRAME:048198/0563 Effective date: 20141219 Owner name: SYNTHES USA, LLC, PENNSYLVANIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:DEPUY MITEK HOLDING CORPORATION;REEL/FRAME:048198/0860 Effective date: 20141219 Owner name: DEPUY SPINE, LLC, MASSACHUSETTS Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:SYNTHES USA, LLC;REEL/FRAME:048829/0673 Effective date: 20141229 |
|
MAFP | Maintenance fee payment |
Free format text: PAYMENT OF MAINTENANCE FEE, 8TH YEAR, LARGE ENTITY (ORIGINAL EVENT CODE: M1552); ENTITY STATUS OF PATENT OWNER: LARGE ENTITY Year of fee payment: 8 |